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House Republican leaders on Thursday presented their rank-and-file members with the outlines of their plan to replace the Affordable Care Act, leaning heavily on tax credits to finance individual insurance purchases and sharply reducing federal payments to the 31 states that have expanded Medicaid eligibility. (Pear and Kaplan, 2/16)

At a closed-door meeting in the Capitol basement, House Speaker Paul Ryan, R-Wis., and other party leaders described a broad vision for voiding much of President Barack Obama's 2010 statute and replacing it with conservative policies. It features a revamped Medicaid program for the poor, tax breaks to help people pay doctors' bills and federally subsidized state pools to assist those with costly medical conditions in buying insurance. Lawmakers called the ideas options, and many were controversial. One being pushed by Ryan and other leaders would replace the tax increases in Obama's law with new levies on the value of some employer-provided health plans — a political no-fly zone for Republicans averse to tax boosts. (Fram, 2/16)

The outline plan is likely to take away some of the financial help low-income families get through Obamacare subsidies, and also result in fewer people being covered under the Medicaid health care program for the poor. "In general this is going to result in fewer people covered nationwide," says Caroline Pearson, a senior vice president at Avalere, a health care consulting group. (Kodjak, 2/16)

According to numerous lawmakers and aides in the room, as well as a policy memo distributed afterward, the House leaders laid out elements of a repeal-and-replace plan — including long-standing Republican concepts like health savings accounts, tax credits and state high-risk pools for the chronically sick. But they did not detail how those elements would fit together or get passed into law. “It’s sort of a smorgasbord right now,” said Rep. Daniel Webster (R-Fla.). (DeBonis and Snell, 2/16)

Members, however, were not provided any concrete language at Thursday’s meeting. “I think they’ve got the outline of the things that will be a part of a bill and part of a reconciliation package going along,” Rep. Ann Wagner, R-Mo., said. “Now we’re getting down to some of the very specifics.” (Williams and Mershon, 2/16)

The proposal seeks in addition to revamp the individual insurance market where millions of Americans who don’t get employer coverage buy insurance. It would replace the health-law subsidies with tax credits Americans could use to help pay for private insurance, and it would allow for skimpier health plans not permitted under the ACA, which some say would help bring down costs. (Hackman, Peterson and Armour, 2/16)

The House GOP approach would preserve a number of features of the existing Obamacare law, including preventing insurers from discriminating against applicants with pre-existing medical problems and allowing children to remain on their parents’ private health care plans until they turn 26. And it would experiment with federally financed, state-run “high-risk pools” that provide coverage to older and sicker Americans who would have trouble finding affordable health insurance in the private market. (Pianin, 2/16)

Ryan told reporters on Capitol Hill that House Republicans would introduce legislation to repeal and replace Obama's program after a 10-day recess that begins on Friday. "After the House returns following the Presidents Day break, we intend to introduce legislation to repeal and replace Obamacare," Ryan said at a press conference. Presidents Day is on Monday and the House returns on Feb. 27. (Cowan and Morgan, 2/16)

Ryan told reporters that the repeal and replace measure will be introduced after the Presidents Day recess. Asked if that meant the week of Feb. 27, the speaker demurred, saying that the bill’s drafters are waiting on cost estimates from the Congressional Budget Office and the Joint Committee on Taxation. “It’s after the recess … pending our drafting our issues,” he said. (McPherson, 2/16)

Newly confirmed Health and Human Services Secretary Tom Price told lawmakers at Thursday's meeting that President Donald Trump “is all in on” repealing and replacing Obamacare at the same time. Earlier this week, the conservative House Freedom Caucus called on Republicans to repeal the law first and work on a replacement later. "Let's not miss this opportunity,” Price said, according to a source in the room. “Let's go shoulder to shoulder, arm to arm.” (Haberkorn, Cheney and Pradhan, 2/16)

Republicans don't have the 60 votes in the Senate needed to enact broader changes to the law, including revising Obamacare's strict insurance rules which are critical to the GOP's promise to make health insurance more affordable. So they plan to repeal the mandates, penalties and taxes using the budget reconciliation process, which is limited to revenue and spending measures and requires only a simple majority to approve. (Luhby, 2/17)

The short- and long-term budget impact of repealing and replacing the 2010 health care law is emerging as a central issue as House Republicans work out the details of their legislative package. The two House committees in charge of writing the reconciliation bill that would repeal and replace Obamacare have not publicly released the text. No official score from the Congressional Budget Office has been written. But several lawmakers on Thursday said they are waiting for the nonpartisan office to weigh in on how elements scrutinized as part of the bill would affect the budget outlook. (Shutt and Krawzak, 2/17)

[F]ormer Obama administration health advisers said the document and its strategy recommendations for GOP lawmakers couldn’t hide the fact that Republicans still hadn’t produced a definitive plan to replace Obamacare. “Because the vast majority of the public has been making clear they do not want their care ripped away from them with nothing else in its place, this is going to be an especially interesting recess period,” said Andy Slavitt, who was the Medicaid administrator under President Barack Obama. (Pugh and Clark, 2/16)

House Republicans, looking for ways to pay for their plan to repeal and replace the Affordable Care Act, are considering changing the special tax treatment for employer-provided health benefits. Capping how much of employees’ health benefits can be shielded from income and payroll taxes is one of the ways GOP lawmakers might offset the cost of their emerging health plan. (Peterson and Rubin, 2/17)

The proposal, still under development, would limit the amount U.S. employers can exclude from workers’ taxes for the health benefits they provide, meaning Americans’ taxes would go up. Excluding premiums from taxes was worth about $250 billion in forgone tax revenue in 2013, according to the Congressional Budget Office. Some health economists have argued that the exemption artificially drives up health spending. (Edney, House and John, 2/16)

The latest Republican plan to repeal and replace the Affordable Care Act, which leaked out Thursday, would target the health care law’s tax on drug makers. It’s not terribly surprising. The GOP has long pledged to undo all of the law’s taxes, and the tax was repealed as part of the test-run bill Republicans passed in 2015. (Scott, 2/16)

Highlights are based on a document distributed to legislators obtained by The Associated Press and interviews with lawmakers, aides and lobbyists. (2/16)

Two Republican lawmakers met Thursday with National Economic Council Director Gary Cohn at the White House to discuss health savings accounts. Sen. Jeff Flake (R-Ariz.) and Rep. Dave Brat (R-Va.) were at the meeting. ... The measure, introduced last month, would nearly triple contribution limits to HSAs and allow for more universal participation in them. Health savings accounts are one of the primary features Republicans are pushing as part of their plan to replace the Affordable Care Act, although GOP leaders have not put forth legislative text. (McIntire, 2/16)

Even no with no consensus replacement for Obamacare in sight, Sen. Ted Cruz is pushing for action on the repeal long promised by Republicans. “What I think is critical at the outset is that we honor the promise we've made to voters for six years running now to repeal Obamacare. We've had three elections — 2010, 2014 and 2016 — that were referenda on repealing Obamacare, and we need to honor that promise,” Cruz said. “Once Obamacare’s repealed, then we need common sense health care reform that expands choices, that lowers prices, and empowers patients to make their own health care decisions." (Lesniewski, 2/16)