The initial GOP proposal to replace Obamacare that was leaked last week is already receiving harsh criticism from some on the right for leaving out policies favored by conservatives while keeping liberal provisions, such as subsidies.
The draft legislation, initially obtained by Politico, makes a number of changes to Obamacare policies, but doesn’t go far enough for some Republicans. The draft is two weeks old and is likely to change before congressional leaders are satisfied with it, according to Republican aides.
One major Republican-favored policy notably absent from the draft is allowing the sale of health insurance across state lines. The policy was most recently touted by President Donald Trump on Monday.
Washington-based Freedom Partners has already criticized the draft for leaving out the coveted provision and leaving too much of Obamacare’s structure in place.
“It shows that former House Speaker John Boehner was onto something when he predicted that Republicans won’t repeal Obamacare, and will actually keep most of its framework intact,” the conservative organization said in a statement Monday. “Rather than passing targeted, common-sense reforms such as allowing people to purchase insurance across state lines or expediting access to live-saving drugs, the House has opted to settle for an Obamacare replacement plan built on government subsidies, higher taxes and regulations.”
One GOP policy favorite which did make it into the draft is increased support for health savings accounts: tax-free funds for those with qualified high-deductible health insurance plans. Many health reform proposals put forth by congressional Republicans coalesce around HSAs because they are believed to increase personal control over health care decisions and demonstrably lower costs.
The draft nearly doubles the amount of money that Americans can save, tax-free, in a health savings account yearly. While HSAs are currently limited to $3,400 for an individual and $6,750 for a family, the proposal would boost that amount to $6,550 for an individual and $13,100 for a family instead.
The content of the legislation limited because Republicans are using the “budget reconciliation” process to ensure swift passage. But conversely, the process is limited only to provisions that deal with federal spending and taxes.
The appeal of reconciliation is that Senate Republicans would be able to pass an Obamacare repeal bill with a simply majority. Without it, Democrats could force the GOP to get a filibuster-proof majority of 60 votes — an unlikely prospect that would require convincing eight Democrats to vote for repeal, in addition to keeping every Republican vote.
That may not be likely, with conservatives and moderate Republicans split on many key provisions.
Republican Rep. Mark Meadows, the chairman of the House Freedom Caucus, told CNN Monday that he would vote down a version of Obamacare repeal that included some of provisions from the draft, particularly the revamping of Obamacare’s income-based premium tax credits into age-based credits instead, and a move to eliminate the tax break for some high-value employer-provided health insurance plans.
“What is conservative about a new entitlement program and a new tax increase? And should that be the first thing that the President signs of significance, that we sent to the new President?” Meadows asked. “A new Republican president signs a new entitlement and a new tax increase as his first major piece of legislation? I don’t know how you support that — do you?”
Meadows told CNN that others in the Freedom Caucus are concerned about the draft legislation as well, although he did not speculate about the outcome.
Trump said that Republicans will be releasing a health care proposal sometime in March.
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