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Thursday, Mar 9 2017

Full Issue

The Big Picture: Who Stands To Gain, Lose Under The American Health Care Act's New World Order

News outlets analyze the specifics of what's in the House Republicans' repeal-and-replace legislation, compare it with Obamacare, identify who wins and loses as a result of its changes, and detail issues such as taxes, subsidies and mental health coverage.

Both Obamacare and the recent Republican replacement proposal use refundable tax credits to help people buy their health insurance. That is part of the reason the new G.O.P. bill is under fire from conservatives, who see it as a new entitlement program. But the structure of the tax credits is really different. Obamacare calculated the credits based on the cost of insurance in a given area and how much the purchaser could afford to pay. The Republican plan hands out tax credits on a flat basis, according to age. (Both plans cut off subsidies at a certain income level, on the assumption that high earners can pay their own way.) That means that the government subsidy you might get under the different plans would depend on a number of factors 鈥 age, income, address. (Quealy and Sanger-Katz, 3/8)

According to a Kaiser Family Foundation study, people who are older, lower-income or live in areas with higher premiums (such as Alaska and Arizona) receive larger tax credits under the Affordable Care Act, also known as Obamacare, than they would under the Republican replacement plan. Some people who are younger, higher-income or live in areas with lower premiums (such as Massachusetts, New Hampshire and Washington) may receive additional assistance under the replacement plan. (Levey and Kim, 3/7)

House Republicans released a bill on March 6 that would repeal and replace the Affordable Care Act. The 123-page bill, named the American Health Care Act, includes major changes to healthcare in the nation. Here's a rundown of some key components of the law to track as markups take place this week. (Meyer, 3/8)

When House Republicans unveiled on Monday a plan聽to replace the Affordable Care Act, one thing was immediately clear: the new approach could create a major shift in taxes for low-and-middle income people聽while delivering a $600 billion聽tax break, primarily to the rich. (Snell, 3/8)

A federal judge in Washington ruled in May that Congress must appropriate money annually for those subsidies. The White House must stop those payments, the judge ruled, even though it could result in chaos for the health care industry. But Republicans have abandoned that stance now that they control the White House and are trying to push health care legislation of their own through Congress. In their health care plan, Republicans keep the payments intact and are poised to treat them as mandatory spending. The flip-flop helps them to the tune of billions of dollars when it comes to assessing the cost of the legislation聽 鈥 a major focus of the debate for the fiscal conservatives and deficit hawks that the backers of the repeal bill need to win over. (Mejdrich and Ruger, 3/9)

Some people across the country who have benefited from the ACA, concerned about Republican efforts to topple the law, are now rushing to get treatments, visit doctors and find alternative ways to pay for their medical costs. Republicans鈥 plan would provide tax credits to help people afford coverage, and it includes a mechanism for patients with certain health conditions. The party has long criticized the ACA, and longstanding opposition to the law among conservatives has powered the Republican repeal efforts. (Armour, 3/8)

President Trump and House Speaker Paul Ryan (R-WI) are promoting the Republican plan to replace the Affordable Care Act in the face of mounting opposition. The plan -- which scraps most of the mandates and tax subsidies in the 2010 Affordable Care Act and replaces them with a new system of tax credits based on age and income -- has drawn sharp fire from conservatives who have dismissed it as 鈥淥bamacare lite鈥 and from Democrats who warn that it would result in millions of Americans losing their health insurance.聽The fate of the plan is highly uncertain at this point. (Pianin, 3/8)

House Republicans who last year made good on longstanding promises to overhaul the mental health system could roll back coverage for millions of people with mental illness and addiction problems by overhauling Medicaid as part of an Obamacare repeal package. Legislation being marked up Wednesday would phase out Obamacare鈥檚 Medicaid expansion, which covers 1.2 million Americans with serious mental illness and substance abuse problems, as well as scrap baseline coverage requirements. The change means certain beneficiaries would no longer get coverage for mental health and substance abuse treatments guaranteed under the Affordable Care Act. (Ehley, 3/8)

The latest Republican health-care bill to repeal the Affordable Care Act would eliminate funds for fundamental public health programs, including for the prevention of bioterrorism and 聽disease outbreaks, as well as money to provide immunizations and heart-disease screenings. (Sun, 3/8)

Republicans鈥 Obamacare replacement will make it easier to sport that beachy, potentially precancerous glow: Their American Health Care Act would do away with a 10 percent excise tax on tanning services...The move is part of the Republican plan to repeal billions of dollars in of levies associated with the law, including the 鈥淐adillac tax鈥 on high-cost health plans, fees on health insurers, and the tanning tax, included in the Affordable Care Act because of indoor tanning鈥檚 link to skin cancer. (Greifeld, 3/8)

People in their 50s and 60s could be hit with higher health insurance premiums and less financial help paying for them under a proposed replacement for the Affordable Care Act. The AARP released a statement opposing the House plan, which is called the American Health Care Act. (Ochoa, 3/8)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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