On Monday evening, Republicans in the House of Representatives offered their alternative to the Affordable Care Act a.k.a. Obamacare. It appears to be similar to a discussion draft that was leaked on February 24. The Republicans’ American HealthCare Act (AHCA) eliminates Obamacare's individual mandate that requires Americans to either purchase health insurance or face a fine. 
 
In a statement, House Speaker Paul Ryan (R-WI) said that the plan will reform the American healthcare system. "The American Health Care Act is a plan to drive down costs, encourage competition, and give every American access to quality, affordable health insurance." Ryan said, "It protects young adults, patients with pre-existing conditions, and provides a stable transition so that no one has the rug pulled out from under them."
 
The legislation preservers two popular features of Obamacare, which allows young men under the age of 26 to remain under their parents’ health plans, while forbidding insurers to deny coverage or charge more to people with pre-existing medical problems. Also, it allows insurers to impose a surcharge on people if they have had a gap in coverage.
 
Democrats were quick to criticize AHCA. Energy and Commerce Committee Ranking Member Frank Pallone and Ways and Means Committee Ranking Member Richard Neal released a statement that claimed that it would have a negative impact on average people. "The Republican repeal bill would rip healthcare away from millions of Americans, ration care for working families and seniors, and put insurance companies back in charge of health care decisions – contrary to everything President Trump has said he would do with his health care plan," said the statement.
 
The bill will have to be marked up by the Energy and Commerce Committee and then passed by the House, debated and passed by the Senate before it becomes law.
 
The tax credits outlined by the Ways and Means Committee’s portion of the legislation incorporates an approach that Republicans have long criticized: income-based aid to help Americans afford health coverage.
 
Republicans had previously steered away from Obamacare subsidies for poor and middle-class people to obtain insurance, having insisted that tax credits should be based entirely on age instead of income. The drafts issued on Monday propose refundable tax credits that are based on income as well as age.
 
Four Republican senators have declared that they would oppose any legislation that leaves large numbers of citizens without insurance coverage. Sens. Shelley Moore Capito (R. W.Va.), Rob Portman (R-Ohio), Lisa Murkowski (R-Alaska), and Cory Gardner (R-Colo.) said they cannot support any bill that denies citizens who became eligible for coverage under Obamacare’s expansion of Medicaid. “We will not support a plan that does not include stability for Medicaid expansion populations or flexibility for states,” they wrote in a letter to Senate Majority Leader Mitch McConnell (R-Ky.).
 
“Reform should not come at the cost of disruption in access to health care for our country’s most vulnerable and sickest individuals. Any changes made to how Medicaid is financed through the state and federal governments should be coupled with significant new flexibility so they can efficiently and effectively manage their Medicaid programs to best meet their own needs,” the letter said.
 
See the bill here.


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Martin Barillas is a former US diplomat and the editor of Spero News.

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