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Republicans to introduce health care replacement bill this week

Republicans will introduce their much-awaited bill to repeal and replace the Affordable Care Act this week, a senior House Republican aide told NBC News on Sunday.

"We are in a very good place right now," said the aide, who asked not to be identified.

AshLee Strong, a spokeswoman for House Speaker Paul Ryan, R-Wisconsin, told NBC News: "We are now at the culmination of a years-long process to keep our promise to the American people."

A draft bill obtained by NBC News would repeal much of the current law, also known as Obamacare, within the next few years and set in place a Republican vision of health care.

Pedro Rojas holds a sign directing people to an insurance company where they can sign up for the Affordable Care Act, also known as Obamacare, before the February 15th deadline on February 5, 2015
Joe Raedle | Getty Images News | Getty Images
Pedro Rojas holds a sign directing people to an insurance company where they can sign up for the Affordable Care Act, also known as Obamacare, before the February 15th deadline on February 5, 2015

The draft legislation would provide expanded tax credits and health savings accounts for individuals while reducing federal spending on tax subsidies and Medicaid and practically eliminating the employer and individual mandates to provide and carry health insurance.

It wasn't clear Sunday night to what extent the draft legislation, dated Feb. 10, may have changed in the last three weeks, but at the time, an aide to a House Republican said: "This is the bones of what's going to happen."

President Donald Trump met with health insurance chief executives at the White House last week to try to win their support for the Republican revamp.

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Only 12 percent of Americans said they had a "great deal" or "quite a bit" of confidence in health insurance companies in a NBC News/Wall Street Journal poll in December. In contrast, 54 percent said they had "very little" or "none at all."

Under the draft bill, Americans who need assistance to buy health care would receive a tax credit — with an option to receive it in advance on a monthly basis — based on age. A person under 30 would be eligible for a $2,000 tax credit, while a person over 60 would be eligible for a $4,000 credit.

The measure would also create state-based high-risk pools for people who don't have access to insurance. The federal government would start providing $15 billion to help fund the high-risk pools next year, but the funding would decrease to $10 billion by 2020 and beyond.

And the legislation would greatly expand the use of health savings accounts, a tax-deductible way to buy health insurance, which has become a top Republican priority.

The largest funding mechanism would be a tax on the most expensive employer-provided health insurance plans.

Outside Trump Tower in New York, health care justice advocates and other grassroots groups gathered to demand that Trump not agree to repeal the Affordable Care Act or attempt to refund Medicare or Medicaid and that he advocate for single-payer healthcare which is the best solution to our current healthcare crisis.
Erik McGregor | Pacific Press | LightRocket | Getty Images
Outside Trump Tower in New York, health care justice advocates and other grassroots groups gathered to demand that Trump not agree to repeal the Affordable Care Act or attempt to refund Medicare or Medicaid and that he advocate for single-payer healthcare which is the best solution to our current healthcare crisis.

The anticipated release of the plan follows a series of town hall meetings across the country during which angry constituents berated Republican lawmakers over health care policy, pouring particular scorn on the idea of tax credits and health savings accounts.

Some Republican senators have already threatened to vote it against it, including Rand Paul of Kentucky, who lambasted the bill-writing process as overly secretive last week.

"The only copy we've seen is from the media," Paul said. "Now we're told it's being classified and the hearing is like a security clearance hearing — you have to have security clearance and permission and have to be on the committee to see the bill."

Making good on promises of "repeal and replace" has proven difficult for Republicans, since members of the party are divided on what a replacement should look like and how much it should cost. Republican leaders, meanwhile, have promised not to "pull the rug" out from under people who are covered by current law.

But the senior House aide told NBC News on Sunday that there was a large staff meeting at the White House on Friday to resolve outstanding issues, while heath care committees in Congress worked over the weekend to incorporate technical guidance.