What changed with the Republican's health proposal? Here's what we know:
Bottom Line: Tuesday night we were told that "tweaks were being made to the Republicans healthcare bill. So what were those tweaks (that are theoretically being designed to address concerns of Republicans that have expressed reservations about the bill)?
- All related Affordable Care Act taxes would be repealed retroactively to January 1st of 2017. The original draft phased the taxes out in 2018
- State work requirements for Medicaid. 23% of households on Medicaid include non-disabled heads of household who aren't working. The new provision would allow states to craft their own rules regarding work requirements to attain eligibility for Medicaid. Additionally states with work requirements would receive additional federal funding for the program.
- Would allow states to attain Medicaid funding for through block-grants. This simplifies the state funding process.
All three of these are moves that are designed to address concerns of conservatives that have called the first version of the Republicans bill "Obamacare Lite". It's unclear if these are enough to win over a majority vote in the House, let alone the Senate, but the effort to provide more control to states over federal mandates for Medicaid along with expedited tax relief are steps in a more traditionally conservative direction. The odds are that they'll be more required in order to secure enough votes to pass an overhaul of the Affordable Care Act. As for my interests... If the first version was 40% less awful than Obamacare, this version might be 45% less awful... In other words, I view these changes as being slightly more than marginally improvements. Once again any system that still embraces the "insurance first" model won't fix the real healthcare issue/crisis which is cost. That will only occur when we have consumer prices and service transparency which is masked by the existing insurance first model.