GOP unveils ACA replacement plan: 11 things to know

Speaker Paul Ryan (R-Wis.) and House Republicans Wednesday unveiled a 37-page healthcare proposal that consolidates the party's ideas to replace the Affordable Care Act. 

"This isn't a return to the pre-Obamacare status quo. And it isn't just an attempt to replace Obamacare and leave it at that," the task force wrote in a summary of the plan. "This is a new approach." 

Here are 11 key details to know about the proposal. 

1. The plan centers around five core principles. These include: 

  • Repeal the ACA.
  • Provide Americans with more choice, lower costs and greater flexibility in healthcare. 
  • Protect the most "vulnerable" patients, such as those with pre-existing conditions and complex medical conditions. 
  • Promote medical innovation. 
  • Preserve Medicare. 

2. The plan includes "universal advanceable, refundable" tax credits for individuals and families that do not have employer-based insurance, Medicare or Medicaid. The tax credits would be available at the beginning of the month to be applied to people's healthcare plan of choice, and would be adjusted by age so that the tax credit grows over time. This is intended to help address the coverage gap of individuals who do not qualify for Medicaid but cannot afford health insurance on their own.  

3. The plan would also adjust the age cap on premiums. The GOP would increase what is called the age-rating ratio, which adjusts premiums based on age. Under the proposed plan, premiums for older individuals would be capped at no more than five times the premium of a younger person. Under the ACA, the age-rating ratio was three to one. 

4. At least $25 billion in federal funding would be dedicated to high-risk pools. States would maintain these programs, which give financial support to people who are priced out of health coverage due to a pre-existing condition. Premiums in these pools would be capped and wait lists would not be allowed. 

5. The GOP proposes providing continuous coverage in individual market. This is a benefit that is already in place in the employer-based health insurance market. Adding continuous coverage protection for individuals would allow them to keep their standard premium rates if they had to switch plans due to a qualifying life event, so long as they have maintained health insurance. 

6. The plan proposes a one-time open enrollment period. This period would allow any uninsured Americans to sign up for coverage. However, those who choose not to enroll at this time will give up continuous coverage benefits, which could lead to higher individual costs. They will still be able to sign up for coverage at any time. 

7. The plan provides a minimum of $25 billion for State Innovation Grants. These grants would be given to states that are able to reduce premiums and the number of uninsured by a certain amount — as a reward for developing effective reforms. 

8. Medicare reforms are also included in the plan. These plans are extensive and include, but are not limited to repealing the Center for Medicare and Medicaid Innovation, combining Medicare Parts A and B, and gradually increasing the Medicare retirement age to match that of Social Security. 

9. Other ideas commonly backed by Republicans were also part of the proposal. These include permitting the sale of health insurance across state lines, converting Medicaid into a state-based block grant program and expanding health savings accounts. 

10. Critics of the proposal say its lack of specifics indicate Republicans are apprehensive. The plan does not include specific dollar amounts for the tax credits and other details that could impact the federal budget. Republicans say it is intended to be a jumping off point, but Democrats say the plan is difficult to assess because it is a whitepaper, not a bill. "The Republicans, frankly, are very apprehensive. A, that they can't get agreement among themselves as to what specific bills ought to be and, B, that if the American people find out before the election, they will be defeated," said Rep. Steny Hoyer (D-Md.), according to The Hill

11. The White House called the GOP's proposal a "political document" and "not worthy" of deliberation. "The proposal they put forward today includes some more details, but the details they put forward today are wildly unpopular, which is why I suspect they will not receive a vote on the floor of the House of Representatives," White House press secretary Josh Earnest said at a press conference, according to The Hill. He also criticized the lack of specificity and "recycled" ideas, accoridng to the report.


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