Republican
politicians have campaigned on repealing President Barack Obama's
healthcare reforms pretty much since they were enacted in 2010.
Now,
with a governing majority, they've had to come up with a replacement
plan - a task that has proved much more challenging than they may have
imagined.
Here's a look at some key differences between the
existing law, informally known as Obamacare, and the American Health
Care Act, crafted by the Trump administration and Republican leadership
in the House of Representatives.
Individual mandate
Obamacare: All Americans are required to have health insurance or pay a tax penalty. Republican plan: The
mandate is repealed, but individuals who forgo health insurance for
more than 63 days must pay a 30% surcharge on their insurance premiums
for a year.
Employer mandate
Obamacare: Companies with more than 50 employees are required to offer health insurance or pay a penalty. Republican plan: This mandate is repealed. Five big consequences of Trumpcare win
Taxes
Obamacare: Raised
Medicare taxes on the wealthy and imposed new taxes on medical devices,
health insurers, drug companies, investment income, tanning salons and
high-end health insurance plans. Republican plan: Repeals most Obamacare taxes and delays implementation of the tax on high-end health insurance plans to 2026.
Insurance for dependents
Obamacare: Required insurers to allow children under age 26 to be covered by their parents' policies Republican plan: Maintains this requirement.
Pre-existing condition coverage
Obamacare: Prohibits insurers from denying coverage or charging more to individuals who have pre-existing medical conditions. Republican plan: Gives
states the option to waive pre-existing coverage requirements if they
set up high-risk insurance plans for individuals who would be priced out
by traditional insurers.
Essential health benefits
Obamacare: Requires
all insurance plans to cover certain health conditions and services,
such as emergency room visits, cancer treatment, annual physical exams,
prescription drug costs, mental health counselling and women's health
services. Republican plan: Allows states to define what benefits are mandated or opt out of the requirement entirely.
Medicaid
Obamacare: Expanded Medicaid health insurance for the poor to cover more low-income individuals. Republican plan: Curtails
federal funding for Medicaid expansion beginning in 2020 and give
states the option to receive federal dollars as a block grant instead of
based on number of enrolees.
Capping expenses
Obamacare: Prohibits
insurers from limiting the amount they would reimburse for expenses for
"essential health benefits" and curbs the annual amount a family must
pay for these benefits. Republican plan: Continues this prohibition and retains limits on so-called out-of-pocket expenses.
Subsidies
Obamacare: Provided
refundable tax credits for low-income individuals who purchased their
insurance on government-run marketplaces and support for some
out-of-pocket medical expenses. Republican plan: Makes
tax credits based on an individual's age, which are phased out at
higher income levels. Ends tax credits for out-of-pocket expenses.
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