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The GOP’s outline of an ACA replacement


Congressional Republicans have come up with the outlines of a plan to replace the Affordable Care Act. Perhaps inevitably in an election year, the plan doesn’t tell us how it would be  financed.  But here are some important elements, as summarized by FierceHealthcare:

“The Republicans’ plan would offer everyone who doesn’t qualify for employer coverage, Medicare or Medicaid access a refundable tax credit to use in the individual market—instead of the ACA’s current policy of offering tax credits to just those of certain incomes. The credit is also age-adjusted.”

The plan would boost “’Association health plans,’ in which small business and groups such as alumni organizations and trade associations band together to offer healthcare coverage at better rates via improved bargaining power with insurers.”

“The plan would set aside at least $25 billion to fund programs that Republicans say would give financial support for those with high medical costs who find themselves priced out of coverage. Premiums for those participating in the high-risk pool would be capped, and wait lists would be prohibited.”

A one-time open enrollment period for the uninsured, regardless of health status. If consumers who lack coverage don’t enroll in a plan during that open enrollment period, they forfeit continuous coverage protections and could face higher insurance costs in the future.”

”The sale of insurance across state lines. This often-cited GOP policy proposal …is supposed to make the insurance market more competitive and give consumers the ability to access the most affordable policies.”

”The preservation of certain ACA protections. The plan would prevent those with pre-existing conditions from being denied coverage, as well as allow individuals to stay on their parents’ insurance plan until age 26.”

”Medicaid reforms that would allow states to choose between either a per capita allotment for their programs or a block grant. States would be allowed the flexibility ‘to charge reasonable enforceable premiums’ or offer a limited benefit package. The proposal also takes several steps to ‘modernize’ the Medicaid demonstration waiver process, requiring them to be budget neutral while grandfathering in some successful waiver provisions.”

For the FierceHealthcare article on the GOP plan, please hit this link.

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