Republicans outline ACA repeal, replacement ideas—but divisions remain

House Republicans are homing in on a set of ideas that will make up the party’s strategy to repeal and replace the Affordable Care Act, though they remain divided on some key issues.

At a closed-door meeting Thursday, GOP leaders presented a healthcare plan that would repeal the individual mandate, replace the ACA’s subsidies with age-based monthly tax credits, allow consumers to purchase less-comprehensive health plans, increase the amount of money consumers could put into health savings accounts and provide grants to states to set up high-risk pools, according to the Wall Street Journal.

Speaking to reporters Thursday, House Speaker Paul Ryan said the GOP was moving full steam ahead with its efforts to dismantle and replace the healthcare law. “After the House returns following President’s Day, we intend to introduce legislation to repeal and replace Obamacare,” he said.

But the meeting also unveiled evidence of continuing divisions within the party. Some Republican lawmakers, for example, aren’t impressed with one proposed way of paying for the plan, which involves capping the tax credit that employers receive to provide health insurance.

House Rules Chairman Pete Sessions, R-Texas, told Politico that such a policy is too similar to the ACA’s controversial Cadillac tax on high-cost employer health plans, which has never taken effect. Similarly, Rep. Tom Cole, R-Okla., told the Associated Press that such a policy "would set up an ad against you from multiple directions" during the upcoming elections.

Republicans’ plan would also end Medicaid expansion, but continue providing expansion states with extra federal money for a “limited period of time,” according to the Washington Post. After that, states would get more leeway to decide who is covered by the program and whether to go with a per capita cap or block grant funding arrangement.

But some GOP governors of states that have expanded Medicaid have told lawmakers they are reluctant to lose the federal funding, potentially creating another political obstacle for the party’s healthcare plans.

Ryan said during his weekly press conference, though, that GOP Senate leaders are working with governors to come up with a solution to keep both expansion and nonexpansion states happy. Congress wants to not only hand more power over Medicaid to the states, he said, but also ensure “that we do it in a way that doesn’t disadvantage either of the two sides of that coin.”