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A Guide for the Perplexed: Understanding “Repeal and Replace”

GOP’s health policy terms defined

President Donald Trump and many congressional Republicans campaigned on repealing the Patient Protection and Affordable Care Act (PPACA) and replacing it with a new plan to overhaul the nation’s health care system. As the GOP constructs its own version of “health care for all,” its representatives are tossing around wonky health policy terms to describe their core strategies. Kaiser Health News has provided some helpful definitions.

  • Budget Reconciliation: A legislative process that allows measures to pass with a simple majority in Congress. Budget reconciliation bills can’t be filibustered, but they must focus on provisions that have a budgetary impact.
  • Essential Health Benefits: PPACA-mandated categories of benefits that health plans must cover. They include emergency services, hospitalization, and maternity care.
  • Health Savings Accounts: These allow consumers to put money away on a tax-free basis as long as they use it for medical expenses.
  • High-Risk Pools: Insurance groups that cover individuals with high health insurance costs, such as people who have a past serious illness or a chronic condition.
  • Individual Market: Where people who do not have health coverage through the government or their employer purchase a plan directly from an insurer. It is sometimes called the nongroup market.
  • Medicaid Block Grants and Per-Capita Caps: The federal government gives states a set amount of money to pay for coverage for Medicaid recipients. This would be a shift from the current Medicaid program, where the federal government matches state Medicaid spending on a percentage basis. 
  • Tax Credits/Subsidies: Financial assistance to help consumers purchase health insurance.

Source: Kaiser Health Care; March 17, 2017.

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