Side by side comparison of obama care and the G.o.p's crap replacement.

A side-by-side comparison of Obamacare and the GOP’s replacement plan
Here’s how the proposed Republican American Health Care Act—along with various amendments to the bill—compares to the 2010 Affordable Care Act.
By NOAM N. LEVEY AND KYLE KIM

MAY 4, 2017

Guaranteed coverage
People with preexisting conditions could see substantial changes in what kind of coverage they could receive.

Under the Affordable Care Act

Americans are able to get health insurance even if they’re sick. This put an end to insurers denying coverage to people who have preexisting medical conditions
Insurers are barred from charging sick consumers more for coverage
Insurers cannot impose annual or lifetime limits on coverage
Insurers must offer a basic set of benefits, including mental health, prescription drugs and maternity care
Insurers cannot charge older consumers more than three times more than younger consumers
Under the GOP proposal

The House GOP plan would not explicitly eliminate guaranteed coverage but would allow states to seek waivers from several consumer protections
States would be allowed to scale back benefits that insurers must cover. Because of the way the law is structured, that could allow insurers to reimpose annual and lifetime limits on some coverage.
States would also be able to allow insurers to charge sick people more, potentially making coverage unaffordable for some
Insurers would be able to charge older consumers five times more than younger consumers
Insurance marketplaces
The insurance marketplace would be intact, but could changed dramatically.

Under the Affordable Care Act

The Obamacare marketplaces, such as HealthCare.gov, enable people who don't get health benefits at work to compare plans, just as they might compare hotel rooms or airline tickets online
All plans on the marketplaces must offer a basic set of benefits, such as hospital care, mental health services and prescription drugs
Under the GOP proposal

It is unclear how the marketplaces would work because insurers might potentially offer health plans that do not offer the same set of benefits
More uninsured
The original version of Republican plan to replace the Affordable Care Act would remove health coverage for an estimated 24 million Americans by 2026, according to independent analysis by the Congressional Budget Office. The hardest hit in the long run would be lower-income Americans and those nearing retirement. Lawmakers from both parties rely on the nonpartisan budget office to gauge the potential impact of legislation.

It is unclear how the revised bill would change this as the Congressional Budget Office has not completed its analysis.

Number of uninsured could nearly double under GOP plan by 2026

0
20
40
60 million
2026
2022
2017
If Obamacare is kept
If Republican plan is adopted
28 million
52 million
Impact on deficit
The initial version of the legislation also would reduce the deficit by $337 billion over the next 10 years largely from Medicaid reductions and the elimination of the ACA's subsidies for nongroup health insurance, the CBO found.

But changes made in recent weeks likely would shrink that substantially. In the end it is unclear how much as the Congressional Budget Office has not completed its analysis.

Annual impact on federal deficit

2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
-100
-30
$40 billion
0
Changes in insurance subsidies
Who wins and who loses under the Republican proposal depends on a few factors. In a nutshell, the new system would provide less help to low-income people and those in high-cost areas. According to a Kaiser Family Foundation study, an American who is older, has lower income and lives in an area with higher premiums like Alaska or Arizona will lose out if the Affordable Care Act, also known as Obamacare, is replaced. An American who is younger, has higher income and lives in areas with lower premiums like Massachusetts or Washington may receive additional assistance under the replacement plan.

Change in assistance between the ACA and Republican replacement

27
Age
$30K
$40K
$50K
$75K
$100K
$20K
Annualincome
40
60
-$3K
+$3K
-$2K
+$2K
-$1K
+$1K
No change
*Older consumers who would pay more under the revised GOP plan may get additional assistance, though how much is unclear.
Under the Affordable Care Act

People using healthcare marketplaces and making less than $48,000 a year receive subsidies to help them buy insurance
The amount of the subsidy is tied to a person's income and to the cost of insurance in the person's area
The subsidies are automatically applied to the consumers’ monthly insurance bills rather than having to wait for a rebate
Under the GOP proposal

People would still receive subsidies, which would phase out at incomes of $75,000 per year
The amount would be tied to a person's age, not income, so low-income people would get less help.
New tax credit proposal

Age
Credit
0
500
1000
1500
2000
2500
3000
3500
4000
60+
50-59
40-49
30-39
20-29
$2,000
$2,500
$3,000
$3,500
$4,000
The subsidies would not vary with the cost of insurance, so people in high-cost areas would also not get as much help
Insurance mandate
Obamacare, for the first time, required Americans to have health insurance. That would no longer be the case.

Under the Affordable Care Act

A person is required to purchase health insurance or pay a tax penalty
Under the GOP proposal

The tax penalty for not having health insurance would be dropped. But consumers would face a different sort of penalty: Anyone who goes without insurance for more than two months would face a 30% premium surcharge when they try to buy a new plan
Percent of Americans with health insurance

80
90
100%
2016
2012
2008
2010ACApasses
2010ACApasses
2014ACA goesinto effect
2014ACA goesinto effect
Women's health
The Republican plan would impose new restrictions on health plans with abortion coverage, and would defund Planned Parenthood. Low-income women would be among the most seriously affected.

Under the Affordable Care Act

Insurance companies cannot charge women more than men for the same health plan
Insurers are required to provide a basic set of benefits including maternity care, pediatric care and contraceptives.
Planned Parenthood receives federal funding for family planning and other medical services used by Medicaid recipients. Abortion cannot be funded with federal dollars
Under the GOP proposal

Insurance companies would still be banned from charging women more
States could seek waivers to allow insurers to drop some basic benefits, such as maternity care and contraceptives
Medicaid would no longer have to offer these benefits, which would impact low-income women. Nearly 80% of Planned Parenthood patients have incomes at or below 150% of the federal poverty level
Medicaid would be barred from providing funding for any health clinics that provide abortion services, including Planned Parenthood
Abortion services make up a small share of Planned Parenthood's overall health services, according to its most recent annual report

Abortion services make up a small share of Planned Parenthood’s overall health services
31%
7%
1%
45%
13%
Other
STD testing/treatment
Cancer screening/prevention
Pregnancy/prenatal services
Contraception
3%
Abortion procedures
Federal subsidies make up the majority of Planned Parenthood's revenue

27%
Private contributions
24%
Non-government
6%
Other
43%
Government grants/ reimbursements
Medicaid
Expanded Medicaid coverage would cease and the funding structure would change.

Under the Affordable Care Act

The federal government and states share the cost of insuring the poor. The amount of money that Washington gives each state varies depending on how much medical care that state's Medicaid patients receive
The federal government is picking up almost the entire cost of expanding Medicaid coverage to low-income adults without children in the 30 states (and the District of Columbia) that have chosen to expand their programs
Under the GOP proposal

A fixed "per capita cap" or a "block grant" would replace the decades-old current system. Each state would have a fixed amount of money every year. That amount would increase annually by a percentage linked to the inflation rate
The additional federal funding that covered expanding Medicaid would be eliminated by 2020
States that adopted Medicaid expansion

AK
HI
MACTRINJDEMDDCWV
WA
MT
CO
NM
AZ
ND
MN
IA
IL
MI
KY
OH
PA
NY
VT
IN
LA
AR
OR
NV
CA
Taxes
Most of the taxes set up under Obamacare to pay for subsidizing insurance would be scrapped. The GOP proposal does not include any new tax to offset the loss of revenue.

Under the Affordable Care Act

Insurance companies and medical device makers, which benefit from new customers under the law, pay more taxes
Taxpayers with incomes over $250,000 are also taxed more
Under the GOP proposal

Medical device makers, insurance companies and wealthy Americans would all receive a big tax cut as these taxes are eliminated
The tax cuts total about $600 billion over the next decade.