All the talk about congressional Republicans preparing to repeal Obamacare may have some Americans on edge, but GOP lawmakers say they intend to craft a plan that will phase out the health care law to ensure a âstable transitionâ for consumers who depend on it.
Republicans say they want consumers to keep their health coverage, and continue receiving any subsidies, until Congress can pass a replacement that may not kick in until 2019.
>>> House Takes Major Step Toward Repealing Obamacare
In the days before Donald Trump is sworn in as president Jan. 20, Republicans are continuing to debate the substance of a bill to repeal the Affordable Care Act, popularly known as Obamacare.
Details are sparse, but conservative senators are urging Senate leaders to use legislation from 2015 as a floor, or minimum, for what should be done this year.
That bill phased out parts of Obamacare over two years, repealed the health care lawâs individual and employer mandates, and did away with fines for not complying. It also eliminated the lawâs Medicaid expansion, medical device tax, and Cadillac tax on high-cost plans.
Congressional committees have started work on a repeal bill. But already President Barack Obama, Democrat lawmakers, and other supporters of the health care law warn that 20 million Americans they say gained coverage under Obamacareâa figure that is disputed as inflatedâare in jeopardy of losing that coverage.
Though Republicans plan to send a bill repealing Obamacare to Trump in the next few weeks, GOP lawmakers are considering delaying implementation of the repeal for two years to protect those who gained coverage under Obamacare.
âThe repeal legislation will include a stable transition period as we work toward patient-centered health care,â Senate Majority Leader Mitch McConnell said on the Senate floor Thursday in a speech mapping out Republicansâ path for repeal.
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A two-year transition before Obamacareâs official repeal takes effect would give Congress time to pass and implement a replacement plan. The goal is to ensure that those who obtained health coverage under the lawâand received tax creditsâwould continue to until the replacement for Obamacare is implemented.
âThereâs more of an understanding that if you just throw 20 to 30 million [insured Americans] out on the street, thatâs not politically wise and, as far as Iâm concerned, immoral,â Timothy Jost, professor at the Washington and Lee University School of Law and a supporter of the Affordable Care Act, told The Daily Signal.
âHow do you deal with that?â Jost said. âI think the idea is you repeal it and put it off for some period of time and adopt and implement a replacement plan.â
Many proposals introduced by Republican members of the House and Senate, including House Speaker Paul Ryanâs âA Better Wayâ plan, include tax credits to provide financial assistance to consumers who purchase coverage in the individual market.
âWe want to have tax credits that give everybody a shot at buying, take their tax credit and go buy a health plan of their choosing,â Ryan said Thursday during a town hall hosted by CNN.
We will replace #Obamacare with a plan that fosters competition, brings down prices, and improves coverage. #RyanTownHall pic.twitter.com/5wSHZBN9Vo
— Paul Ryan (@SpeakerRyan) January 13, 2017
Republicans âgenerally are not talking aboutâ ending all subsidies, Jost said. But since they havenât yet introduced a replacement for the health care law, he said, it isnât clear whether tax credits will be based on a consumerâs age or income.
Republicans may agree it will take time to eliminate Obamacare without imperiling Americansâ insurance status, but GOP lawmakers remain split over aspects of the repeal legislation itself.
Some Republican senators, for example, would like to see a repeal of Obamacareâs taxes delayed for several months, while others say the taxes should be rolled back immediately after Trump signs the repeal bill into law.
The 2015 reconciliation bill, which members of the last Congress said plotted the steps for successfully dismantling Obamacare, repealed all of the lawâs taxes immediately. Obama vetoed that bill.
Alyene Senger, a policy analyst at The Heritage Foundationâs Center for Health Policy Studies, advocates following the model set by the 2015 legislation and repealing the taxes immediately. Included are taxes on prescription drugs and health insurers, as well as higher restrictions and penalties placed on health savings accounts.
Other Republican lawmakers want to see GOP leaders produce a replacement plan before they vote to repeal Obamacare.
At first, House conservatives advocated a repeal-first, replace-later strategy. Now, though, theyâre backing a plan to replace the law soon after voting to repeal it.
Congress took a major step toward repealing Obamacare this week after members passed a budget resolution for fiscal 2017. The resolution instructs committees in the House and Senate to begin writing the bill to repeal the law using a process called reconciliation.
>>> Video: The Process Republicans Are Using to Repeal Obamacare, Explained
After the November election, Republican lawmakers said they planned to have a bill repealing Obamacare on Trumpâs desk not long after his inauguration Jan. 20.
But Trump has begun to set his own expectations for Congress.
At his first press conference since the election, the president-elect Wednesday mapped out a timeline for Obamacareâs repeal and replacement that centers around Senate confirmation of Rep. Tom Price, R-Ga., his pick to run the Department of Health and Human Services.
âWeâre going to be submitting as soon as our secretary is approved, almost simultaneously, [or] shortly thereafter, a plan,â Trump said. âIt will be repeal and replace.â
The Senate Finance Committee, which has primary jurisdiction, hasnât scheduled a confirmation hearing for Price.
The Georgia Republican will appear at a courtesy hearing next Wednesday before the Senate Health, Education, Labor, and Pensions Committee. Republican Sen. Lamar Alexander of Tennessee, chairman of that panel, said earlier this week he doesnât expect Price to be confirmed until mid-February.
Under Trumpâs timeline, that would delay repeal of Obamacare until at least then.
But GOP leaders in Congress hope to move faster.
We want a health care system that allows Americans to access quality, affordable care. That's not what #Obamacare does. #RyanTownHall pic.twitter.com/G4zNi2T6l9
— Paul Ryan (@SpeakerRyan) January 13, 2017
Ryan said Thursday that congressional Republicans are âmoving as quickly as they canâ to repeal and replace the health care law. But, Ryan admitted, it will take âa little bit of time.â
âThe law is collapsing,â Ryan said, âand so weâve got to rescue people from the collapsing of this law and fix this problem.â