House Republicans on Monday released long-awaited legislation to repeal and partially replace the 2010 health care law, which has evolved to accommodate various concerns raised about leaked drafts of the bill.
The measure, however, does not have a cost estimate from the Congressional Budget Office, longstanding practice to evaluate the effects of such legislation. The House Ways and Means and Energy and Commerce committees are scheduled to mark up their portions of the legislation on Wednesday without the CBO score.
“This will proceed through a transparent process of regular order in full view of the public,” House Speaker Paul D. Ryan said in a statement.
However, it wasn’t clear if the legislation, should it make it through the House, would go through the Senate committees of jurisdiction.
“Let’s let them go through the regular order, and we’ll move through our part,” Senate Health, Education, Labor and Pensions Chairman Lamar Alexander said. Asked if the bill would go through Senate committees or straight to the floor, the Tennessee Republican said, “Let’s see.”
The portion that Ways and Means will mark up no longer includes a cap on the tax exclusion for employer-provided plans as a means to pay for the bill.
Instead, the measure bumps the effective date for repealing various taxes created under the health care law to Jan. 1, 2018 and would reintroduce the so-called Cadillac tax on high-end insurance plans to comply with Budget rules.
The penalties associated with the current law’s individual and employer mandates would be repealed immediately and applied retroactively to the 2016 tax year.
The Energy and Commerce portion would freeze Medicaid expansion enrollment as of Jan. 21, 2020. That coincides with the availability of refundable tax credits proposed under the Ways and Means bill.
The credits, which will begin phasing out at incomes of $75,000 for individuals and $150,000 for joint filers, would be made available for individuals who do not receive coverage under an employer-provided plan; the amount of the credit varies by age.
Conservatives had opposed the idea of a refundable tax credit, seeing it as the creation of an entitlement.
With the employer exclusion cap removed, the individual tax credit capped and Medicaid expansion addressed, it’s possible some members’ views on the legislation may shift.
Sen. Shelley Moore Capito said she had not read the House bills but described the changes on Medicaid as positive compared to the original draft.
“It looks like they’ve moved toward a better transition period and more flexibility for governors, an ability for the Medicaid expansion population to have the assurance that they are not going to be left out in the cold,” the West Virginia Republican said.
Asked if the changes were enough for her to support the bill, Capito said, “It’s moving in the right direction.”
White House Press Secretary Sean Spicer released a statement to the pool that said President Donald Trump “looks forward to working with both Chambers of Congress to repeal and replace Obamacare.”
Bridget Bowman, Niels Lesniewski, John T. Bennett and Andrew Siddons contributed to this report.