These notes are gathered from the 66 page “Budget Reconciliation Legislative Recommendations Relating to Repeal and Replace of the Patient Protection and Affordable Care Act” are based on the health plan proposal that was released today.
- In general, this turns regulation of public health care requirements over to states but requires that they operate within prescribed program parameters
- Defines an institution that performs an abortion as a prohibited entity not eligible for funding
- Ends Medicaid expansion
- Removes Essential Health Benefits after 2019
- Allows insurers to raise premium rates 30% if there is a gap in coverage more than two months
- Allows age-based insurance rates
- Repeals ACA taxes starting in 2018
- Includes extensive details on disenrolling lottery winners as a means to reduce health care costs
This publication does not discuss the tax credits. I published preliminary notes on the more extensive leaked proposal last week.
The most striking thing about Republican health plan, if I’m understanding it correctly, is that the continuous overage provision will increase the number of uninsured who but coverage only when they need medical treatment. The 30% premium surcharge will not deter people from dropping coverage while healthy.
The second most notable thing is that the drafts appear to be conceived with little or no stakeholder input. IMO, this significantly reduces the potential for effective operation over the long term.