Republicans are expected to release legislation this week to repeal and replace the ACA, Reuters reported.

Dive Brief:

  • A newer draft of Republican legislation to repeal and replace the ACA includes changes to eligibility for tax credits to help people buy insurance, Politico reported.
  • The latest draft, which has not publicly been released, is not likely to appease hard line conservatives who opposed an early replacement draft bill because they thought the credits were too generous.
  • The draft also includes a change to state innovation grants meant to help stabilize individual markets. Insurers would be able to be reimbursed for sicker, costlier beneficiaries up to $350,000.

Dive Insight:

The GOP has been scrambling to appear on the same message regarding repealing, replacing or repairing the ACA.

Last week, an earlier draft of the bill surfaced and drew criticism from both sides of the aisle. Some Republicans did not think the earlier draft dismantled enough of the ACA repeal (some likened it to “Obamacare Lite”) while Democrats railed the proposed legislation noting it could decrease access to healthcare for large groups of individuals.

President Donald Trump addressed ACA replacement in his joint address to Congress this week. He said new legislation should ensure people with pre-existing conditions had coverage and allow plans to be sold across state lines. He also advocated for tax credits to help buy coverage, health savings accounts and tort reform.

Lawmakers from both parties put on a show Thursday when they heard a newer draft bill existed but they would not be able to see it. They searched the Capitol for the supposed bill but came up empty.
Politico reported it had looked at the elusive bill but did not upload any documents. No Republicans disputed the Politico report.

The change to tax credit eligibility could please some lawmakers concerned that provisions like health savings accounts favor the wealthy over those with lower incomes. But the credits would still be based on age and not income, as they are under the ACA. Credits based only on age are likely to be insufficient for those who do not quite qualify for Medicaid but are close to the federal poverty level. This would lead to fewer people continuing to be able to afford coverage in general.

The bill is still subject to changes before being introduced and the GOP is also awaiting a score from the Congressional Budget Office.

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