We've all been in suspense, chasing the details of what House Republicans will do to replace Obamacare — and now it's clear we could have been reading House Speaker Paul Ryan's "A Better Way" plan the whole time. The briefing document from yesterday's House Republican meeting sticks closely to the Ryan plan from last year, at least in the parts it includes.
The big things that are being picked up from "A Better Way":
- Tax credits (fixed amounts, based on age, not income)
- Health savings accounts
- Medicaid reform (choice between per-capita caps and block grants)
- "State Innovation Grants" (can be used for high-risk pools)
The big pieces that are left out:
- Limiting the tax breaks for employer health coverage (Republicans are still talking about it)
- Medicare "premium support" plan (President Trump's not interested)
The backstory: None of this should be a surprise. Ryan has been the driving force in the House on health care reform all along, and he noted yesterday that his former colleague, Health and Human Services secretary Tom Price, was "one of the primary architects" of the Better Way plan. The Senate still has to buy off on it, but the thinking among House GOP aides is that the House has more leverage because Ryan has been working on these ideas for years.