With a little over two weeks left before Donald Trump becomes president, millions of Americans are bracing themselves for what could be the end of their health care coverage under the Affordable Care Act (Obamacare).
The big question is, “What exactly, will Trump and Republican lawmakers do to replace this coverage?”
Dismantling Obamacare is the top priority for the majority of lawmakers as they return to work this week. Sixty votes are needed in the Senate to outright repeal and replace Obamacare—a number that Republicans do not have. GOP House Speaker Paul Ryan is hoping some provisions can be changed instead.
The good news for Obamacare enrollees is Republicans don’t have a clear replacement yet. They will likely need more time to work out the details, such as coming up with a solution to cover those with pre-existing conditions and low-income Americans, which are often costly to insure. This will buy Obama enrollees more time—maybe as long as two years—to get the medical attention they need under current conditions and, hopefully, prepare for possible premium hikes.
Here's what a Republican plan to replace Obamacare may look like, according to CNN:
Basically, Republican-style healthcare would eliminate federal subsidies and funding for Medicaid expansion, and cancel a multitude of Obamacare-related taxes.
Instead of providing federal subsidies to help people afford their premiums, Republicans would give refundable tax credits to those who buy policies in the individual market. People would save from $1,200 to $3,000 depending on their ages. Older people will receive higher credits.
Middle class Americans, who make too much to qualify for Obamacare subsidies, would benefit more than those with lower and moderate-incomes. Currently, Obamacare enrollees who do receive the subsidies, can lower the cost of coverage to just under 10% of their annual income.
Those who are currently covered could not be dropped from their plans or be prevented from renewing them because they are sick. And insurers can't charge them higher premiums.
Republicans would set up a two-track system to cover people with pre-existing conditions: one for those who maintain continuous coverage and one for those who don't. For those with a pre-existing condition who haven't maintained continuous coverage, the GOP would bring back state-based high-risk pools, which were largely shut down after the Obamacare exchanges became operational in 2014. This option would cost an estimated $178 billion a year, according to a 2014 Commonwealth Fund report.
Republicans would limit how much the federal government spends on the health insurance program for the poor. Most plans call for providing states with a fixed amount of money under a block grant program or a set grant per enrollee, known as a per capita grant. The GOP would also encourage states to design plans that fit their needs.
Meanwhile, the Obama administration and Democrats are gearing up for a battle. They want to encourage uninsured Americans to sign up for Obamacare coverage or renew their policies. They point to the record number of those who signed up for coverage and have launched a campaign for enrollees to share stories of how Obamacare has helped them, using the hashtag #CoverageMatters.
Minority Leader Nancy Pelosi is requesting that other congressional members hold events in mid-January, highlighting the risks of Republicans' plans for Obamacare and Medicare.
Enrollment under Obamacare is closing soon. Sign up by Jan. 15, 2017 to begin coverage on Feb. 1, 2017, online at Coveredca.com or by calling (800) 300-1506.