GOP Releases Health Plan

NFU President Cautions Against Changes that Could Cost Rural Residents Health Insurance

House Republicans officially kicked off their efforts to repeal and replace the Affordable Care Act with the release of a new bill on Monday. (DTN file photo)

SAN DIEGO (DTN) -- As Republican House leaders released their plan to repeal and replace the Affordable Care Act, National Farmers Union President Roger Johnson said here Monday that dealing with health care will be at the top of the list of issues Republicans have to address before the farm bill.

Johnson cautioned that if the ACA is repealed, millions of Americans will again turn to emergency rooms for primary health care.

Johnson spoke about health care in his annual address to the NFU membership at its annual meeting here just before House Republicans released their plan that their leaders say will repeal and replace Obamacare.

Johnson, who served as agriculture commissioner of North Dakota from 1996 to 2009, said that when he traveled around the state and asked farmers to name their biggest problem, "the most common answer I got ... was health care. The last few years I don't hear people saying that. If we repeal the Affordable Care Act, those voices are going to be front and center again."

Noting that 20 million to 30 million people nationwide have taken out health insurance under the ACA, Johnson said, "If premiums go up enough, people will drop it and go to the emergency room and everyone else will pay for it."

According to details released from the House Energy and Commerce Committee, the House Republican plan would replace federal insurance subsidies with a new form of individual tax credits and grants to help states shape their own policies. The House Energy and Commerce Committee has scheduled a markup of the bill on Wednesday.

The bill would continue to allow people to stay on their parents' health plan until they are 26, and would forbid insurers to deny coverage or charge more to people with pre-existing medical problems.

The bill replaces Obamacare's premium subsidies by income with a range of tax credits for people that would go up with age. The tax credits would start at $2,000 a year for people under 30 and increase to $4,000 for people over age 60. Tax credits for a family would be capped at $14,000 a year. The tax credits would phase out for individuals making incomes above $75,000 a year or couples with incomes above $150,000.

While older Americans would get a higher tax credit, the bill would allow insurers to charge more for covering older people than the caps set under the Affordable Care Act.

The bill repeals the individual mandate under Obamacare. Under the legislation, rather than a tax penalty through the IRS, the plan creates a 30% premium penalty for people who go longer than 63 consecutive days without health insurance coverage.

Large employers also would be allowed to drop health insurance coverage, as the bill repeals the employer mandate.

States would be given the option to create "Patient and State Stability Funds" to help high-risk people who do not have access to insurance through an employer to enroll in a state pool.

The details released Monday do not reflect any new proposals that would make it easier for small businesses to provide insurance to their workers. The bill also does not specify any details about health savings accounts.

The bill also dials back the Medicaid expansion in 31 states within three years of the bill going into law and would set fixed amounts to pay states each person on Medicaid.

But the House bill's future is far from certain. Four key Republican senators, all from states that opted to expand Medicaid under the ACA, said they would oppose any new plan that would leave millions of Americans uninsured.

"We will not support a plan that does not include stability for Medicaid expansion populations or flexibility for states," Republican Sens. Rob Portman of Ohio, Shelley Moore Capito of West Virginia, Cory Gardner of Colorado and Lisa Murkowski of Alaska wrote in a letter to Senate Majority Leader Mitch McConnell, R-Ky.

Chris Clayton can be reached at

Follow them on Twitter @ChrisClaytonDTN and @Hagstromreport