Last week, House Republicans submitted their bill to repeal and replace the Affordable Care Act, also known as Obamacare.
The bill, which has been under intense committee debate, has drawn criticism from Democrats, some Republicans, health care organizations, doctors, and others. But it is largely supported by House Republicans and the White House.
Some of the bill’s provisions would be enacted as soon as it is put into law, including the elimination of individual and employer mandates. Others would be delayed until 2020, such as limiting the Medicaid expansion and a repeal of subsidies for out-of-pocket expenses.
The Republican legislation has yet to be voted on in the House, and it is unclear whether it could pass in the Senate.
But if it does make it through, how would the new health care law affect Michiganders?
As one of the 31 states to expand Medicaid coverage, Michigan would see a major change in Medicaid availability and funding.
Enrollment under the expansion would halt in 2020. People that gained coverage under the expansion previously would continue to be covered, but new enrollments or re-enrollments would not be allowed.
The Healthy Michigan Plan currently covers over 600,000 beneficiaries, many of whom are in rural areas that voted for Trump.
The Michigan Department of Health and Human Services has not yet released any information about how the GOP bill would affect Michigan, saying the details are still under review.
The way Medicaid is funded would change, too. According to NPR:
Currently, Medicaid costs are shared between states and the federal government, but the funding is open-ended, so the federal government pays its percentage of whatever states spend. Under the proposed bill, the amount of federal funding would be capped on a per-person basis, so funding would go up as more people qualify. But that per-capita amount might not grow as fast as Medicaid costs, which could leave states on the hook for an ever-increasing share of the costs of the program.
Other changes include ending a requirement that Medicaid cover mental health and addiction services, which could pose a challenge for Michigan as the number of opioid addictions continues to rise. It would also cut off all federal funding for Planned Parenthood, which has 20 locations across Michigan.
Michigan’s representatives respond
Most of Michigan’s Republican representatives in the House support the bill, but there is one notable objection.
Rep. Justin Amash called the bill “Obamacare 2.0,” saying it is just a repackaging of the Affordable Care Act, which he wants to see fully repealed. Amash is the only Michigan congressman that belongs to the House Freedom Caucus, a conservative coalition which opposes the bill.
There's nothing "wonderful" about GOP plan. It repackages Obamacare, breaks promises & doesn't lower costs.
Justin— Justin Amash (@justinamash) March 7, 2017
Amash posted his opinion on Facebook last week, saying, “The new Republican plan does not repeal/replace Obamacare; it repackages Obamacare. It's a political plan that signals retreat and will not reduce health care costs.”
Democratic representatives also disagree with the bill, and are planning to fight it.
In a statement, Rep. Dan Kildee called the bill dangerous.
“No law is perfect, including Obamacare, and I have always maintained that I will work with anyone, Democrat or Republican, to improve the law. But repealing the ACA, kicking millions off their current health care plans, is irresponsible and dangerous.”
Rep. Brenda Lawrence called out the GOP plan to defund Planned Parenthood in her objection, saying the move would unfairly target women.
What’s next for the bill...and Michigan
The battle over health care is far from over. The GOP bill is facing a lot of resistance from both parties as well as major interest groups.
The bill is still under House committee debate. Later this week, the Congressional Budget Office will release its projections about the impact of the plan, which could influence the bill’s future success.
Either way, the Affordable Care Act will likely be changing within the next four years. And Michigan will change with it.