Updated version of ACA repeal, replacement bill leaks

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Despite Republicans' efforts to keep their healthcare bill under lock and key, another version of the legislation leaked Friday.

Just one day after some lawmakers staged a public hunt for Republicans’ closely guarded Affordable Care Act repeal and replacement bill, a draft of the legislation has yet again been released to the press.

While the latest version of the draft legislation has many similarities to a previously leaked draft, it also includes some notable differences, according to Politico, which obtained a copy of the bill.

They include:

  • The removal of a section that would have allowed “grandmothered” or transitional plans to remain in the market indefinitely. The Trump administration recently announced it will extend the life of such plans, which are exempt for the ACA’s essential benefits requirements, through 2018
  • The creation of a reinsurance fund for states that fail to take advantage of the “state innovation grants” meant to help states stabilize the individual marketplaces. It would reimburse insurers for customers with medical claims that exceed $50,000, with a cutoff point of $350,000
  • Changes to the eligibility rules to receive tax credits, plus a verification process for people who are employed to prove that they don’t get insurance through their jobs

Though the legislation contains no specific provision to cut off tax-credit eligibility for wealthier Americans, GOP staffers were told to come up with proposals to do so, according to Politico.

Some of the more conservative Republicans have railed against including tax credits at all, calling them a new entitlement program. But in his recent address to Congress, President Donald Trump included the concept of providing tax credits in his outline of five main ACA replacement principles.

In his weekly press conference Thursday, House Speaker Paul Ryan downplayed suggestions that Republicans are split over how to repeal and replace the ACA, saying, “I am perfectly confident that when it is all said and done, we are going to unify,” FierceHealthcare reported.  

Like its predecessor, the latest draft of the GOP bill contains a plan to phase out the Medicaid expansion, the Politico article added. Some Republican governors, however, were reported to be in the process of drawing up a compromise plan to keep some elements of expanded Medicaid eligibility.