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February 23, 2017

ACA replacement plan may come as soon as March, Trump says

Daily Briefing

    President Trump on Wednesday said he expects a health care reform plan to be released as soon as next month, although it's unclear whether the plan would be developed by the White House or how it would fit in amid the range of other GOP health care proposals.

    White House could release its own replacement plan

    According to a press pool report, Trump told reporters he expects a plan to come out "maybe mid-to-early March," adding that "we'll be submitting something that I think people will be very impressed by." However, it is unclear whether Trump was referring to a White House, congressional, or joint plan, The Hill reports.

    During a press briefing later in the day, White House Press Secretary Sean Spicer referred to "the president's plan" when discussing the administration's goal of repealing and replacing the ACA. According to Roll Call, Spicer did not rule out the possibility Trump might release his own replacement proposal.

    A House GOP leadership aide said discussions with the White House are ongoing, Roll Call reports. House GOP leaders released their latest proposal to repeal and replace the Affordable Care Act (ACA) last week, and, according to Roll Call, relevant House committees plan to mark up their own replacement plans in March. The House version would then go to the Senate for amendment.

    House GOP outlines ACA replacement plans

    Repeal effort faces divisions among Republicans

    Meanwhile, congressional efforts to repeal and replace the ACA are facing unanswered questions, including what to do about Medicaid, The Hill reports.

    Repealing the ACA would end the law's Medicaid expansion, as well as federal funding for states that opted to take advantage of it. Republicans are split about what should happen next: Some want to keep the expansion or at least maintain it during a transition period, while others want the expansion repealed immediately with the rest of the law.

    The latest House proposal would roll back federal funding for the Medicaid expansion and put the onus on states to secure funding.

    Sen. John Thune (R-S.D.) said it is "probably the thorniest and most difficult issue to resolve." He added, "You don't want to punish or penalize states that didn't expand [Medicaid], but the states that did expand are going to say, 'We don't want to get punished for expanding, either.'"

    Sen. Rand Paul (R-Ky.) said, "There's still division. There are some people who want to keep part of Obamacare."

    Republicans appear to coalesce on expanding HSAs

    While Republicans remain split on Medicaid, they seem to agree on expanding access to health savings accounts (HSAs). According to The Hill, every replacement plan proposed so far would expand HSAs in some way.

    Paul said HSAs would help drive down overall health care costs, which would help "everybody."

    But Karen Pollitz, a senior fellow at the Kaiser Family Foundation, said that HSAs don't work well for everyone, noting, "Low-income people can't afford to put any money away, and if they had extra money, they're not getting many tax benefits from [the HSA's tax exemption] at all" because of their low income tax rates (Bennett, Roll Call, 2/22; Sullivan, The Hill, 2/22; Bolton/Sullivan, The Hill, 2/22; Hellmann, The Hill, 2/22).

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