Mr Trump has also suggested he may lift sanctions against Russia. In quotes The Trump - Putin relationship China could be on his agenda, although he backtracked on one campaign pledge. Mr Trump has said in the past he would label China a currency manipulator after he takes office.
Elimination of Individual Mandate One of the differences between the GCHJ and the ACA is that the individual mandate, the IRS penalty assessed on those who do not purchase health insurance, is not only eliminated but is repealed retroactively to Many experts believe that the elimination of the mandate with nothing to encourage health individuals to purchase health insurance could lead to higher insurance premiums because insurance companies would view the pools as limited to high-risk customers.
The Commonwealth Fund reported that between 15 and 18 million people could become uninsured as soon as This is not necessarily due to the inability to afford insurance, but because healthy people will no longer be required to pay for healthcare and may choose not to spend money on those premiums.
Elimination of Insurance Subsidies The GCHJ also eliminates insurance subsidies under the ACA that allow insurance companies to offset out-of-pocket expenses and premium costs for low-income families. One of the reasons for their lack of support was that the elimination of subsidies increased uncertainty in the insurance marketplace.
Although there is funding included in the bill to keep the market stable, some believe that the individual market could collapse before in some states.
However, the bill allows states to apply for a waiver so that insurance companies in those states can charge higher premiums for pre-existing conditions if they can prove that doing so significantly decreases premiums for everyone else. Experts say that this practice eliminates important protections for members of the insurance marketplace who suffer from chronic illnesses like diabetes, cancer or heart conditions.
In its place, the federal government would issue block grants to each state using a complicated formula loosely based on how many people in that state fell between 50 and percent of the federal poverty level. This new funding approach could result in significant financial losses for at least four states that make up 37 percent of all federal Medicaid funding: New York, Massachusetts, California and Maryland.
Elimination of the Medicaid expansion is estimated to leave 26 million without insurance by The law also allows states to require able-bodied Medicaid recipients to work. Challenges to Block Grant Program Not only is the formula for the GCHJ Medicaid block grant program complicated, but states will also be required to draft legislation and may need to create agencies as well as administrative guidelines for using the federal funding.
All of this will need to be done while states wait for the federal government to set their own rules. It will be challenging to put all of that in place by States that expanded Medicaid under the ACA stand to lose a significant amount of funding while states that chose not to expand may see funding increase.
Some states may see no change in their federal funding but will have more autonomy in how the funds are spent. Catastrophic Plans Under the ACA, only adults up to age 30 can purchase catastrophic plans in the marketplace. These are plans that cover serious health conditions like cancer, heart disease or significant injuries and little else.
The GCHJ plan allows all adults to purchase such plans, which often come with much lower premiums than those that cover a full bevy of benefits, including the 10 essential health benefits required under Obamacare major medical policies.
In addition, the GCHJ bill eliminates the requirement that all insurance policies cover those 10 essential health benefits, which includes maternity and mental health care, among other key services. Analyses suggest that eliminating the essential health benefits provision could lead many people with substance abuse problems to lose coverage for critical treatments.
Deadline For Passage Republicans do not have much time to get the bill passed. Under Senate rules, the bill must be passed by September 30 with a simple majority in order to avoid a Democratic filibuster. The Congressional Budget Office has said that it will take several weeks to review the bill to determine what impact it may have on coverages and costs.
Therefore, the bill could be passed without a review by the CBO. Many also worry that the Republicans are desperate to pass the bill to make good on campaign promises, which may make them less likely to review the bill thoroughly before they take a vote and pass it.
Currently, only Senator Rand Paul has stated he is opposed to the measure and would prefer a bipartisan effort to replace the ACA. Bill Expiration One significant problem that the bill faces is the third phase, which will occur in At that time, all appropriations and funding expires.
Congress will be required to pass new legislation and create a new healthcare program plus a funding source. States that choose to expand under the GCHJ could face significant shortfalls when that occurs.
Many report that this bill is not significantly different than bills presented earlier in the year. Although one of those bills passed the House of Representatives, it failed to garner votes in the Senate. A Senate measure designed to replace it failed.
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