(Bloomberg) — Republican leaders in Congress may scrap a provision in the House GOP’s Affordable Care Act de-funding proposal that would require insurers to charge a 30 percent penalty to customers who go without coverage for at least 63 days.
“There was discussion of the 30 percent penalty for people” who don’t maintain continuous coverage, said Rep. Phil Roe of Tennessee, a medical doctor and member of the GOP Doctors Caucus. He said lawmakers were “looking at it — and saying, is this going to discourage people from getting insurance?”
John Cornyn, the No. 2 Republican senator, confirmed that scrapping the 30 percent surcharge is “being discussed,” but added, “I’m not aware of any decisions.” The Texan said the goal is to craft a bill that can pass the House and Senate.
Republicans face a narrow path for getting the health care measure through the House, particularly after the Congressional Budget Office estimated it could add 24 million Americans to the ranks of the uninsured in a decade. House leaders said they hope to put the measure up for a vote next week, but said the timing could slip. The House Budget Committee is set to advance the measure Thursday.
“The House bill does so much for you,” President Donald Trump said at a political rally in Nashville on Wednesday. “It repeals hundreds of billions of dollars in Obamacare taxes. It provides tax credits for people to purchase the care that is rightfully theirs.”
The bill, he said, “will get rid of Obamacare and make health care better for you and for your family.”
Vice President Mike Pence told House Republicans Wednesday afternoon that they’ve arrived at an important “moment of history,” according to Ways and Means Chairman Kevin Brady.
Pence told the meeting that several changes to the bill are on the table, including changes to the phaseout of the ACA Medicaid expansion and the new bill’s work requirement. But he avoided making any commitments on the various — and sometimes conflicting — changes being sought by different factions of House Republicans.
“We’re all collaborating to make sure we get this exactly right,” House Speaker Paul Ryan told reporters Wednesday evening. He said Trump’s administration is involved in working out the House bill.
Building a healthy pool
The 30 percent penalty — designed as a substitute for Obamacare’s requirement that almost everyone have health coverage — is aimed at encouraging young and healthy people to buy insurance.
Because the House health care bill requires insurers to cover people with pre-existing conditions, economists say that rule must be paired with provisions to entice healthy people to get covered in order to avoid a sick and costly risk pool. Some lawmakers, however, are worried that the 30 percent penalty would have the opposite effect of discouraging more young people from buying insurance.
Roe said if it were dropped, it would need to be replaced with something else.
“There needs to be an encourager,” he said. “Right now, we have a mandate and many people are obviously choosing not to take it.”
It was unclear Wednesday what, if anything, would be the substitute. Roe said discussions of how to amend the bill are an “ongoing process.”
Trump said in Nashville that “at the very core of Obamacare was a fatal flaw: the government forcing people to buy a government-approved product.”
John Thune has a plan to make the AHCA tax credit bigger for people with less than $40,600 in annual income. (Photo: Diego Radzinschi/NLJ
‘Drive down premiums’
One suggestion by Texas Sen. Ted Cruz, is to scrap the requirement to cover pre-existing conditions along with other insurer regulations, which he called the “principal driver of skyrocketing premiums.”