Now that House Republicans have unveiled their plan to repeal and replace the Affordable Care Act, reviews and analyses are pouring in.
The plan calls for a full repeal of the ACA and policies to replace it that include the establishment of high-risk insurance pools, changes in how Medicaid is funded and selling insurance across state lines, among others. The “A Better Way” document, however, is just a framework designed to be built upon by a Republican-controlled Congress, a staff aide has said.
Here’s a brief rundown of some of the early takes on the GOP's healthcare policy ideas:
- A Kaiser Family Foundation issue brief takes an in-depth look at one of the plan’s proposals, which would convert federal Medicaid financing from an open-ended entitlement to a per-capita allotment or a block grant. The idea of a per-capita cap, which has been floated before, would give states additional flexibility and budget predictability while controlling federal outlays, KFF says. But there are drawbacks: For instance, it could be administratively difficult, could maintain current inequities in per enrollee costs across states and could give states incentives to reduce Medicaid payment rates and restrict benefits.
- Forbes contributor Michael F. Cannon takes a critical view of the plan, writing that “House Republicans would repeal Obamacare only to replace it with slightly modified versions of that law’s worst provisions.” For example, he argues the plan’s idea to give every eligible person tax credits to buy insurance on the individual market would preserve much of the ACA’s entitlement spending and give the federal government as much control over the content of individuals’ health plans as the ACA’s individual mandate. He did, however, praise some of the plan’s ideas, such as expanding the use of health savings accounts and limiting federal spending on Medicaid.
- On the flip side, the Republicans' plan has a fan in Douglas Holtz-Eakin, who was Sen. John McCain's top economic adviser during the 2008 presidential campaign. Holtz-Eakin tells Politico on its “Pulse Check” podcast that the plan is a “victory” for the GOP after it was accused repeatedly of having no idea about how to replace the ACA. It’s also good news for presumptive Republican presidential nominee Donald Trump, whose unpredictability means that a healthcare proposal that has been vetted by top lawmakers is all the more valuable, Holtz-Eakin says.
- In a blog post for The Wall Street Journal, meanwhile, Kaiser Family Foundation President and CEO Drew Altman wonders if the Republicans’ plan, combined with a new report from the Medicare trustees, will heighten the visibility of Medicare in the 2016 presidential election. Trump may come under pressure to support all or part of the plan--after having said he wouldn’t touch Medicare if elected--and Democrats will likely emphasize the major differences between the parties with respect to Medicare’s future, he writes.