Employers would no longer face a tax for offering high-value "Cadillac" health plans under the latest House Republican plan to repeal and replace Obamacare.
Two House committees are scheduled to vote on the plan Wednesday, GOP leaders announced late Monday. House Speaker Paul Ryan, R-Wis., plans to send the bill to the House floor for a vote and then forward it to the Senate by the beginning of April. The two panels, which have put forth slightly different versions of repeal and replace, are the House Ways and Means and the Energy and Commerce committees.
The latest version of the legislation, formally released by GOP leaders, contains a few important changes from the draft leaked to reporters last week. The changes are meant to draw critical support from conservatives worried that the original plan didn't do enough to rein in the costs of the Affordable Care Act, the health reform law enacted during Barack Obama's tenure in the White House. It also attempts to address worries of some GOP governors that the earlier incarnation of the Obamacare repeal plan would force them to impose too steep cuts in Medicaid.
The 123-page bill, now formally named the American Health Care Act, would, like the draft leaked previously, replace the ACA's income-based tax credits with age-based tax credits that in most cases would be smaller than what Obamacare offers.
It also would eliminate plans to increase federal funding for states' expansion of Medicaid, the insurance program for the poor. Medicaid would also be converted from an open-ended entitlement to one that provided capped, per-capita payments to the states.
The bill would retain funding for a Medicaid expansion until 2020. Subsidies for insurance purchases on Obamacare exchanges also will stay in place until 2020.
Despite Ryan's aggressive timeline, the legislation still faces major obstacles. Conservatives are likely to oppose keeping the Obamacare coverage expansions for three more years.
Also, the Congressional Budget Office has not yet issued its assessment of the bill's cost and impact on coverage levels. That's important because the bill must reduce the federal deficit by $2 billion over 10 years in order to meet budgetary instructions to ensure the bill qualifies as a budget reconciliation package. Meeting that criteria for budget reconciliation will allow the package to pass the Senate with a simple majority rather than a filibuster-proof 60-vote margin. Many of the most right-leaning Republicans oppose the bill's refundable tax credits to help people afford insurance.