House Republicans on Monday released their long-awaited plan for unraveling former President Barack Obama's health care law--a package that would scale back the government's role in health care and likely leave more Americans uninsured.
In San Diego County, more than 385,000 people would be immediately impacted by repealing the Affordable Care Act.
House committees planned to begin voting on the 123 page legislation Wednesday, launching what could be the year's defining battle in Congress and capping a seven-year Republican effort to repeal the 2010 law.
The plan would repeal the statute's unpopular fines on people who do not have health insurance. It would replace income-based subsidies the law provides to help millions of Americans pay premiums with age-based tax credits that may be less generous to people with low incomes. Those payments would phase out for higher-earning people.
But the bill would continue Obama's expansion of Medicaid to additional low-earning Americans until 2020. After that, states adding Medicaid recipients would no longer receive the additional federal funds the statute has provided.
More significantly, republicans would overhaul the federal-state Medicaid program, changing its open-ended federal financing to a limit based on enrollment and costs in each state.
Jan Spencley and San Diegans for Healthcare Coverage help thousands of the uninsured sign up for healthcare each year.
"We provide direct assistance with enrolling in coverage, with retaining coverage, problems with coverage, access to care, but we also provide advocacy," Spenley said. "We're serving working individuals. We have very few people who have no income."
Dismantling the Affordable Care Act comes at no surprise to many.
President Trump, during much of his campaign vowed to repeal and replace Obamacare.
There will also be language in the bill preventing Planned Parenthood federal dollars to fund abortions.
"The reality is everybody would be impacted to one extent or another. Benefits would be impacted because the Affordable Care Act did in fact require that at least some benefits are provided," Spencley said.
The Energy and Commerce Committee and the Ways and Means Committee will examine their parts of the bill on Wednesday, when changes could be made.
The bill must then go to the Budget Committee and the Rules Committee before heading to the full House.