GOP senators unveil ACA replacement proposal

Plan released on the eve of President Barack Obama's State of the Union address

Three Republican senators--Richard Burr (R-N.C.), Tom Coburn (R-Okla.) and Orrin Hatch (R-Utah)--released a legislative framework yesterday to repeal the Affordable Care Act and replace it with alternative solutions to the healthcare crisis, Kaiser Health News reported. The Patient Choice, Affordability, Responsibility, and Empowerment Act (CARE) would revoke the ACA's individual and employer mandates, cancel Medicaid expansion, lower tax credits for buying insurance, and eliminate ACA-related taxes and fees, KHN noted.

The new GOP plan gives states reform-related discretionary power: States that find CARE provisions overly or insufficiently restrictive could pass laws opting out of the provisions for plans they regulate. For example, states could reject a requirement to cover dependents though age 26 or opt out of revised provisions barring payers from charging older customers more than five times what they charge young adults. And states would have more flexibility to customize and administer their Medicaid programs, according to the proposal.

"For millions of Americans, Obamacare itself has become a preexisting condition that has caused them to lose their insurance, their doctors and their choices," Coburn said yesterday in an announcement. "Congress has a responsibility to not only repeal this misguided law but replace it with a plan that will provide better care at a lower cost, and will help preserve programs like Medicaid instead of driving them closer to bankruptcy."

Under CARE, insurers can't charge continuously-covered Americans more for a pre-existing medical condition, but those with interrupted coverage could eventually pay more based on health history. The proposal also keeps the ACA's ban on lifetime benefit maximums. And employers could still deduct the cost of providing health insurance benefits. But employees with rich benefit plans would need to pay taxes on the value of some benefits, KHN reported.

The senators will work with colleagues and healthcare experts to refine the proposal before introducing legislation, said Hatch's office. The plan's current form hasn't been scored by the Congressional Budget Office, according to CQ Roll Call.

For more:
- see the Kaiser Health News article
- read Hatch's announcement and proposal (.pdf)
- here's the CQ Roll Call blog post

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