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AP file photo

The House Republican proposal to repeal and replace Obamacare will repeal the Medicaid expansion in its "current form" and replace it with per-capita caps, or limits on funding for each person in the program, according to a document given to members obtained by Axios.

States that expanded Medicaid would continue to receive enhanced federal funding for the expansion population during a transition period. But over time, the federal funding would be decreased to the state's traditional match rate. Obamacare required the federal government to pay for the entirety of the expansion for the first three years, eventually phasing down to 90 percent.

"This ensures continuity of care and coverage for low-income adults, but does not reward states that expanded Medicaid under Obamacare and allows individuals to cycle off the program into other coverage sources naturally," the document says.

States that didn't take the expansion would be eligible to "receive additional temporary resources" for safety net providers to help make things more equal between states, the document says.

While a per capita cap would be the default option for states, they could also choose to receive a block grant. The block grant wouldn't include funding for the expansion population and would assume those individuals find coverage outside of the Medicaid program.

Other pieces of the proposal:

  • Increasing the annual maximum health savings account contribution to equal the maximum out-of-pocket spending levels, which are limited by law.
  • "State innovation grants," which would be given to states to use however they wanted to "help lower the cost of care for some of their must vulnerable patients." Basically, they could be used to help set up high risk pools.
  • A universal, age-based tax credit for people buying coverage on the individual market.

Not included:

  • A cap on the tax break for employer insurance benefits, which is typically one of the main sources of revenue for GOP health plans. Aides and members say this is still likely to end up in the final package.
  • Many important numbers, such as the value of the tax credit or how much the per capita Medicaid payment would increase over time. These are crucial details.

Go deeper

Biden administration releases long-awaited Khashoggi report

Photo: Bandar Algaloud / Saudi Kingdom Council / Handout/Anadolu Agency via Getty Images

The Office of the Director of National Intelligence (ODNI) has released an unclassified report assessing that Saudi Crown Prince Mohammed bin Salman (MBS) approved the operation to "capture or kill" Washington Post journalist Jamal Khashoggi in 2018.

Why it matters: The grisly October 2018 murder of Khashoggi inside the Saudi consulate in Istanbul sparked worldwide outrage and calls for the U.S. to fundamentally reevaluate its relationship with the Gulf kingdom.

Updated 23 mins ago - Politics & Policy

Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Health: Most COVID-19 survivors can weather risk of reinfection, study says — "Twindemic" averted as flu reports plummet amid coronavirus crisis
  2. Vaccine: Employers mull COVID vaccine requirements — New data reignites the debate over coronavirus vaccine strategyPfizer begins study on 3rd vaccine dose as booster shot against new strains.
  3. Economy: What's really going on with the labor market.
  4. Local: All adult Minnesotans will likely be eligible for COVID-19 vaccine by summer — Another wealthy Florida community receives special access to COVID-19 vaccine.
  5. Sports: Poll weighs impact of athlete vaccination.

Democrats call for briefing on legal justification for Biden's Syria strike

Sen. Tim Kaine. Photo: Erin Schaff-Pool/Getty Images

Sens. Tim Kaine (D-Va.), Chris Murphy (D-Conn.) and Rep. Ro Khanna (D-Calif.) are among the Democrats criticizing the Biden administration for Thursday night's airstrike against facilities in Syria linked to an Iran-backed militia group, demanding that Congress immediately be briefed on the matter.

Why it matters: The strikes, which the Pentagon and National Security Council say were a response to threats against U.S. forces in the region, constitute the Biden administration's first overt military action.