Republicans in the U.S. Congress are working to overhaul the nation's health care laws in their effort to repeal and replace the Affordable Care Act, considered by some to be one of former President Barack Obama's most significant legislative achievements.
U.S. media outlets reported details Friday of potential replacements for the health care law, frequently referred to as Obamacare. The details were obtained from draft legislation circulating among lobbyists and congressional staff.
One proposal would cap the amount of money the federal government gives to states for Medicaid, the government health insurance program for the poor, which was expanded under Obama. The Washington Post reported that another idea gaining traction would allow those who gained access to Medicaid when the program was expanded to keep their benefits, while additional enrollees would be excluded.
End to subsidies
The Republicans' draft would end income-based tax subsidies to help individuals purchase health insurance. It also calls for tax credits of up to $4,000 for people 60 years or older, but would allow insurers to increase the rates they charge older people.
The Associated Press reported that Republican governors from seven states want Medicaid to change from an open-ended federal entitlement to a program designed by each state, within a financial limit. Ohio Governor John Kasich leads the group, which is said to be concerned that a new law could shift high health care costs from Washington to the states.
Public opinion surveys indicate a broad majority of Americans oppose repealing the health care law unless lawmakers can come up with an acceptable substitute plan.
President Donald Trump, along with many Republicans in Congress, campaigned on a pledge to repeal Obamacare, but the party's lawmakers have since faced complaints that simply abandoning Obamacare would leave millions of Americans without any protection against high-cost medical emergencies. Republicans say they expect to decide on a replacement for the present law in the coming weeks.
Vice President Mike Pence, painting the legislative situation in dramatic terms, said Friday that "America's Obamacare nightmare is about to end."
Pledge, but no details
"President Trump and I want every American to have access to quality and affordable health insurance," Pence said, "which is why we're designing a better law that lowers the cost of health insurance without growing the size of government." He did not, however, give details of the "better law."
Congressional committees are still working on the new bills under consideration, and the proposals will still face a period of debate in the full Congress.
Democratic lawmakers argue the existing law has helped slow the rise in Americans' health care spending and brought coverage to the poor. They also note the current plan guarantees insurance for people with long-standing health problems, to whom insurers often had denied coverage in the past.
Democrats passed the Affordable Care Act in 2010, when they had majority control of both houses of Congress. Republicans have opposed the law since its passage, and they tried more than 50 times unsuccessfully to repeal it during the Obama administration. Trump's party argues that prices are too high for Affordable Care Act insurance coverage, and that individual states should have more control than the federal government over the issue.
The health care law has enabled 20 million previously uninsured Americans to obtain coverage, but it has been plagued by difficulties, including rising premiums and some large private insurers' decisions to leave the system.