The GOP's latest proposal to repeal and replace the Affordable Care Act hews closely to the earlier bill that didn't win enough support among lawmakers to bring to a vote.
Perhaps the biggest change in the document released Thursday is that it leaves in place the Affordable Care Act taxes on wealthy individuals. It uses that money to reduce the number of people left without insurance coverage by the law's changes. This latest version adds $70 billion to a fund for states — bringing the total to $132 billion — to help support coverage of low-income people.
It also would allow insurance companies to offer health plans without the consumer protections included in the Affordable Care Act, or Obamacare. That means insurers could sell stripped-down policies that cover fewer conditions and offer fewer benefits than currently allowed under the law.
Those plans would very likely be cheaper than the policies currently offered on the Obamacare exchanges. But for people who would like to purchase plans that cover the essential health benefits mandated by the Affordable Care Act, including mental health coverage, addiction treatment, maternity care and prescription drug coverage, costs could go way up.
The nonpartisan Congressional Budget Office hasn't yet analyzed the new bill. It weighed in on the earlier Senate bill, saying that proposal would result in 22 million fewer people having health coverage in the next 10 years, compared with under the Affordable Care Act. Of those, 15 million would lose Medicaid coverage. That version was projected to lower the deficit by billions over 10 years — but that may have changed as the latest version offers billions more for state grants and also doesn't repeal as many of the Obamacare taxes.
Yet this new variant is the same as its predecessor when it comes to subsidies to help individuals pay for insurance. It would mostly reduce subsidies and cause out-of-pocket costs to rise, as the CBO said about the previous bill. It's not yet clear how the state grants would alter that dynamic.