New Republican legislation would repeal the ACA’s individual mandate and employer shared-responsibility requirements but leave much of the law in place. In introducing the “World's Greatest Healthcare Plan,” Sen. Bill Cassidy of Louisiana and Rep. Pete Sessions of Texas acknowledged the political and practical hurdles to completely repealing the ACA even under a GOP administration.
While the proposal is at odds with the views of many Republicans who seek total repeal and replacement of the law and comes as a House GOP task force develops a white paper aimed at that goal, the two lawmakers hope their more moderate position might ultimately draw bipartisan support.
In addition to repealing the individual and employer mandates, the bill would let states opt out of the ACA and into a new set of Republican-backed insurance reforms featuring a “universal tax credit” that could be used either in the individual market or, subject to certain tax-benefit recapture provisions, to buy coverage through an employer plan. Employers could offer health reimbursement arrangements to help employees buy individual coverage.
But the legislation would leave much of the ACA’s infrastructure in place, including many of the law’s consumer insurance protections (e.g., ban on pre-existing condition exclusions, child eligibility to age 26), health insurance exchanges, Medicare reforms, and nearly all of the law's revenue-raising provisions. Omitted are many familiar GOP health care proposals, such as interstate insurance sales and medical malpractice reform, though the bill seeks greater price transparency and a per-capita limit on Medicaid funding.