(CN) – House Republicans released draft legislation Monday night to repeal the federal health care law and replace it with a new regime built upon refundable individual tax credits and grants to help states shape their own plans.
House committees planned to begin voting on the 123-page bill on Wednesday, launching what could be the year’s defining battle in Congress and capping a seven-year Republican effort to repeal the 2010 Patient Protection and Affordable Care Act.
On Monday night GOP leaders said they expect their measure to win the backing of the Trump administration, but acknowledged deep divisions among their colleagues remain.
The bill introduced Monday does away with the individual mandate, but maintains coverage for people with pre-existing conditions. It also allows children to stay on their parents’ insurance plans until the age of 26.
The plan would replace the income-based subsidies the law provides to help millions of Americans pay premiums with age-based tax credits that may be less generous to people with low incomes. Those payments would phase out for higher-earning people.
The bill would continue President Barack Obama’s expansion of Medicaid to additional low-earning Americans until 2020. After that, states adding Medicaid recipients would no longer receive the additional federal funds the statute has provided.
More significantly, Republicans would overhaul the federal-state Medicaid program, changing its open-ended federal financing to a limit based on enrollment and costs in each state.
Critics of the individual components of the plans that have been floated in recent weeks claim the policies espoused by Republican lawmakers could result in millions of people losing access to insurance they received under the Affordable Care Act.
While the GOP plan largely keeps protections for pre-existing conditions in place, the bills would also allow insurers to charger higher premiums to those who allow their coverage to lapse.
The draft bills, which are currently in two House committees, go on to eliminate penalties for Americans who fail to purchase health insurance.
House Speaker Paul Ryan, R-Wis., said the bill would “drive down costs, encourage competition, and give every American access to quality, affordable health insurance.”
“This unified Republican government will deliver relief and peace of mind to the millions of Americans suffering under Obamacare,” he added.
But if Republicans appear to have preliminarily achieved their goal of coming up with a plan to replace the Affordable Care Act, also known as Obamacare, with a more conservative healthcare policy, some in their caucus say the draft plan doesn’t go far enough.
On Monday night, Sen. Rand Paul, R-Ky., who opposes income-based tax credits, tweeted, “Still have not seen an official version of the House Obamacare replacement bill, but from media reports this sure looks like Obamacare Lite!”
The Republican tax credits — ranging from $2,000 to $14,000 for families — would be refundable, meaning even people with no tax liability would receive the payments. Conservatives have objected that that feature creates a new entitlement program the government cannot afford.
Senate Finance Committee Chairman Orrin Hatch, R-Utah, wouldn’t rule out changes in the measure by his chamber, where significant numbers of moderate Republicans have expressed concerns that the measure could leave too many voters without coverage.
“The House has the right to come up with what it wants to and present it to the Senate by passing it. And we have a right to look it over and see if we like it or don’t,” Hatch told reporters Monday night.
And shortly before the bill was unveiled, four GOP senators released a letter to Senate Majority Leader Mitch McConnell, R-Ky., in which they complained that an earlier, similar draft of the measure “does not provide stability and certainty for individuals and families in Medicaid expansion programs or the necessary flexibility for states.”
The Associated Press contributed to this report.