INDIANAPOLIS, Ind. – Hours after unveiling their long-awaited plan to repeal and replace the Affordable Care Act, House Republican leaders went on a sales pitch Tuesday to ensure fellow lawmakers and constituents the anticipation was worth it.
The plan would no longer require Americans to have health insurance and instead rely on a new system of tax credits to encourage people to purchase insurance on the open market. Several popular provisions would also remain, like a measure that allows youth to stay on their parents’ insurance plan until they’re 26 and also forbids insurers from denying coverage to anyone with a pre-existing condition.
The plan also would phase out and cap the expansion of Medicaid.
“We restore state control of healthcare so it can be designed for the families and communities in each state,” Rep. Kevin Brady said Tuesday, the House Ways and Means Chairman.
The goal, Republican leaders said, is to provide more flexibility to states like Indiana’s HIP 2.0, one of 31 states that expanded Medicaid under the Affordable Care Act.
“You give the states more responsibility, which I support, but when you do that you also put the cost of that program more squarely on their shoulders,” State Senate President Pro Tem David Long (R-Fort Wayne) said last week. “So that’s going to be our challenge. How do you afford it?”
The plan would keep the Medicaid expansion in place through 2020. After that, though, the government’s payment would only cover people currently eligible under the expansion, with federal dollars quickly subsiding as those people drop off. Currently the federal government covers 95 percent of Medicaid expansion, which drops to 90 percent by 2020.
“We’ll have to re-evaluate the program, the HIP 2.0 program and the number of clients it serves, the state’s support for it,” State House Speaker Brian Bosma (R-Indianapolis) said last week. “I’m not saying it would go away, but certainly a major portion of funding for that is no longer available.”
HIP 2.0, a plan Vice President Mike Pence negotiated with the Obama administration as Indiana governor, currently covers about 420,000 Hoosiers, state health officials said Tuesday. The state-funded portion includes payments from hospitals and revenue from the state cigarette tax.
“Honestly it’s not shocking to me that the federal government might not fully fund something they said they would fully fund,” Bosma said. “It’s not the first time we’ve been through that.”
Long said Indiana lawmakers are still in “the discussion phase,” especially given the fact the House GOP plan is by no means an instant slam-dunk.
Already some members of the House Freedom Caucus have expressed serious concern Medicaid would be expanded through 2020. Instead they’d like to see federal dollars cut immediately and the entire Affordable Care Act repealed.
“Sure there’s a legitimate policy debate here,” Rep. Luke Messer (R-Ind.) said in an interview with FOX 59 last week in Washington. “But I think in many ways President Trump will be the tie-breaker. He’ll be the referee.”
Congressional Democrats have shown no signs of cooperation in the new measure, quickly denouncing the new plan as unnecessary.
“This effort is simply to undermine President Obama’s legacy,” Rep. Andre Carson (D-Ind.) said.
House committees are expected to begin work on the legislation Wednesday, including the Energy and Commerce Committee, which Rep. Susan Brooks (R-Ind.) sits on.
“This bill, which is available online tonight for the American people to read, is a good first step,” Brooks said in a statement.
Indiana Gov. Eric Holcomb has yet to state publicly whether he supports the specific proposed changes to Medicaid outlined in the plan. Holcomb is joining a number of Republican governors who will submit their own recommendations to Congress in the coming days.
"The House has taken the correct first step to repeal Obamacare," Holcomb said in a statement. "We will continue to work on the replacement that is best for Hoosiers while pursing improvements to our HIP 2.0."