Health care politics Still,should Republicans retake the House and Donald Trump be reelected,it could breathe new life into the AHCA. (Photo:Shutterstock)

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Everything old is new again—at least when it's a Republican planto do away with the Affordable Care Act.

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Fierce Healthcare reports that a "new" health care plan producedby the Republican Study Committee—a group of 145 HouseRepublicans—looks an awful lot like the American Health Care Act, which Republicanspassed in 2017 when they still held the House majority. And theAHCA was actually a big motivator behind voters' handing a loss oftheir majority to House Republicans.

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Still, should Republicans retake the House and Donald Trump bereelected, it could breathe new life into the AHCA. In that case,here are some of the changes it would propose.

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Related: AHCA continues to bring out thecritics

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While the plan would continue to require, as does the ACA, thatpre-existing conditions be covered, it wouldchange how that happens by devolving to high-risk pools that would,according to the report, "be funded by repackaging the funding usedfor the ACA's subsidies and the Medicaid expansion."

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The trouble with that is that the new plan doesn't specify howmuch funding should be put towards those high-risk pools, which,according to a 2017 Milliman report, could require between$3.3–$16.7 billion a year. When the AHCA championed high-riskpools, it only advocated providing $2.5 billion annually to fundthem—and there's no assurance that funding provided by this latesttake would come up to scratch either.

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The plan also advocates again for Health Savings Accounts andproposes substantial boosts in allowable contributions: $9,000 perindividual and $18,000 for families. It would also allow HSA fundsto be used for health services and products that currently are notapproved for pretax-dollar purchase.

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The plan purports to improve health coverage portability butallows people to be subject to an exclusion period for preexistingconditions if they haven't had a year's worth of continuouscoverage—although there are provisions to shorten that exclusionperiod and "the 63-day grace period for gaps in coverage would bemaintained under the RSC plan," the RSC report says.

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Last but not least, it would drop current Medicaid expansionfunding back to pre-expansion levels while replacing the currentopen-ended structure with block grants. It adds a "flex-grant"aspect that would provide states adding work requirements with moremoney than states that lack them. Half of that additional funding,however, must go toward private plan purchase for low-incomeparticipants.

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In addition, the fly in the ointment here is that of the 12states that have already gotten approval from the Trumpadministration to add work requirements, three have already hadthose work requirements struck down in court.

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