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Republicans just announced big changes to their Obamacare replacement bill days before a crucial vote

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House Speaker Paul Ryan and President Donald Trump

House GOP members are set to roll out a large batch of changes to their American Health Care Act, the bill to repeal and replace Obamacare, according to Politico’s Jennifer Haberkorn, Rachael Bade, and Josh Dawsey.

The moves come as House Speaker Paul Ryan, GOP leaders, and President Donald Trump’s administration try and lock down the necessary votes for the bill to pass the House.

Here’s a rundown of the key changes, as reported by Politico:

  • A $75 billion fund to finance larger tax credits for Americans between 50 and 64 years old. The current flat tax credit structure of the AHCA gives 50 to 59 year olds $3,500 annually to help pay for insurance and people 60 years old and above $4,000 annually. Analysis by health policy experts have shown this would lead to a signifcant increase in premiums costs compared to the ACA’s current tax credits. The changes would give seniors more support to pay for insurance.

    Importantly, the amendment does not explicitly set out how this fund would work, but instead directs the Senate to hash out those details. This means the House leaders are asking Republicans to vote on a bill providing a large increase in funding without knowing the details of how that funding will be distributed.

  • Move up the date of the Obamacare taxes repeal. Taxes that help fund the credits — on everything to healthcare executives making over $500,000 to tanning beds — would be repealed a year ahead of the current AHCA timeframe. This appears to be an appeal to conservative House Republicans who say that the law does not go far enough or quickly enough in its repeal of Obamacare.
  • Allow states to create work requirements for Medicaid. While 77% of Medicaid beneficaries are in households with a worker, Republicans have desired a provision that would allow states to mandate non-disabled people would have to be working in order to qualify for Medicaid.
  • Allow states to shift Medicaid funding to a block grant sytem. The current AHCA shifts funding for Medicaid expansion to per capita block grants, but the new provision would allow states to shift their funding for Medicaid to a simple block grant.

The moves come as Trump’s White House tries to wrangle conservative votes in the House and Ryan tried to convince moderate Republicans to get on board.

Mark Meadows, the head of the conservative House Freedom Caucus, said before the package of changes that he had enough votes to block the law.

The House Rules Committee will consider the AHCA on Wednesday and a full vote on the bill is expected in the House on Thursday.

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