CLOSE Skip in Skip x Embed x Share Former House Speaker John Boehner is speaking out about the repeal and replace message Republicans have about Obamacare. Veuer's Nick Cardona (@nickcardona93) has the story. Buzz60 
 
 Pattye McAbee, of Carney, Okla., asks a question of U.S. Rep. Frank Lucas, R-Oklahoma, during a town hall meeting in Chandler, Okla., Wednesday, Feb. 22, 2017. McAbee said that she had voted for Hillary Clinton and wanted Congress to leave Obamacare alone. (Photo: Sue Ogrocki, AP) 
 
 Publicity surrounding the Affordable Care Act's benefits may be meeting supporters' goals. More people view the health law favorably than at any point in nearly seven years. 
 
 That's the main finding of a Kaiser Family Foundation survey out Friday of 1,160 people last week that shows the Affordable Care Act is as popular as it's been since the summer of 2010. 
 
 The percent of people with favorable views of the law increased from 43% in December to 48% now. People are still split on whether to repeal the law or not — though far fewer want repeal without details of a replacement plan. 
 
 "It’s not surprising that as Democrats have gone on the offense about the benefits of the law for people, support for the law has gone up," says Paul Howard, director of health policy at the free market Manhattan Institute. 
 
 More than 1,160 adults were polled Feb. 13-19 for the survey,which has a margin of error of plus or minus 3 percentage points. 
 
 A lack of clarity over what the law would be replaced with if repealed strengthens attachment to the ACA, says Howard. Republican infighting weakens support for the repeal effort and supporters of the law have made "effective use of town halls" in congressional districts, he added. 
 
 "The devil you know is more popular than the devil you don't," says Howard. 
 
 Liz Hamel is director of public opinion and survey research at the Kaiser Family Foundation. (Photo: Kaiser Family Foundation) 
 
 While Democrats and Republicans' opinions of the law haven't changed much, independents seem to have grown more positive about the ACA, says Liz Hamel, Kaiser Family Foundation's director of public opinion and survey research. 
 
 "They're most likely reacting to what they’re hearing in the news and the fact that more of the public discussion of late is about what people stand to lose if it is repealed," says Hamel. 
 
 The new findings come as insurers and consumers are trying to figure out what to make of Internal Revenue Service guidance on how it would treat tax returns that that appeared to suggest taxpayers without health insurance won’t face penalties at tax time. 
 
 In recent years, returns that didn't indicate whether the taxpayer had insurance or an exemption were processed, but that was set to change this year. Based on one of President Trump's executive orders, the IRS now plans to continue processing these returns and may follow up at a future date. 
 
 Read more: 
 
 "Legislative provisions of the ACA law are still in force until changed by the Congress, and taxpayers remain required to follow the law and pay what they may owe‎," the IRS said. 
 
 The insurance industry trade group, America's Health Insurance Plans, is urging Congress to approve other incentives to keep people enrolled in insurance if the tax penalties are eliminated. If people aren't required to buy insurance, healthy people are more likely to wait to buy it when they are sick or injured and their premiums couldn't offset the costs of insuring those who need more health care. 
 
 Other findings: 
 
 • Nearly half of the public worry someone in their family will lose coverage if the ACA is repealed and replaced. 
 
 • Substantial majorities say it is important that any ACA replacement plan continue to provide federal funds to states that expanded Medicaid under the law. This was true no matter where people lived or what political party they belong to. 
 
 • About two thirds of people prefers status quo over such changes that would limit federal spending while giving states more flexibility to decide who and what to cover. 
 
 Read or Share this story: http://usat.ly/2meTvNc ||||| House Speaker Paul Ryan promised that Republicans would begin marking up a repeal bill next week. | Getty Exclusive: Leaked GOP Obamacare replacement shrinks subsidies, Medicaid expansion The replacement would be paid for by limiting tax breaks on generous health plans people get at work. 
 
 A draft House Republican repeal bill would dismantle the Obamacare subsidies and scrap its Medicaid expansion, according to a copy of the proposal obtained by POLITICO. 
 
 The legislation would take down the foundation of Obamacare, including the unpopular individual mandate, subsidies based on people’s income, and all of the law’s taxes. It would significantly roll back Medicaid spending and give states money to create high risk pools for some people with pre-existing conditions. Some elements would be effective right away; others not until 2020. 
 
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 The replacement would be paid for by limiting tax breaks on generous health plans people get at work — an idea that is similar to the Obamacare “Cadillac tax” that Republicans have fought to repeal. 
 
 Speaker Paul Ryan said last week that Republicans would introduce repeal legislation after recess. But the GOP has been deeply divided about how much of the law to scrap, and how much to “repair,” and the heated town halls back home during the weeklong recess aren’t making it any easier for them. 
 
 The key House committees declined to comment on specifics of a draft that will change as the bill moves through the committees. The speaker's office deferred to the House committees. 
 
 In place of the Obamacare subsidies, the House bill starting in 2020 would give tax credits — based on age instead of income. For a person under age 30, the credit would be $2,000. That amount would double for beneficiaries over the age of 60, according to the proposal. A related document notes that HHS Secretary Tom Price wants the subsidies to be slightly less generous for most age groups. 
 
 The Republican plan would also eliminate Obamacare’s Medicaid expansion in 2020. States could still cover those people if they chose but they’d get a lot less federal money to do so. And instead of the current open-ended federal entitlement, states would get capped payments to states based on the number of Medicaid enrollees. 
 
 Another key piece of the Republican proposal: $100 billion in “state innovation grants” to help subsidize extremely expensive enrollees. That aims to address at least a portion of the “pre-existing condition” population, though without the same broad protections as in the Affordable Care Act. 
 
 It also would eliminate Planned Parenthood funding, which could be an obstacle if the bill gets to the Senate. And it leaves decisions about mandatory or essential benefits to the states. 
 
 According to the document, there’s only one single revenue generator to pay for the new tax credits and grants. Republicans are proposing to cap the tax exemption for employer sponsored insurance at the 90th percentile of current premiums. That means benefits above that level would be taxed. 
 
 And while health care economists on both sides of the aisle favor tax-limits along those lines, politically it’s a hard sell. Both businesses and unions fought the Obamacare counterpart, dubbed the Cadillac tax. 
 
 The document is more detailed than the general powerpoint House leaders circulated before the recess. Lawmakers are still in disagreement about several key issues, including Medicaid and the size and form of subsidies. Discussions within the House, and between House leaders and the White House about the final proposal are ongoing. President Donald Trump, who gives a major speech to Congress on Tuesday night, has said he expects a plan will emerge in early to mid March. 
 
 The exact details of any legislation will also be shaped by findings from the CBO about how much it will cost and what it will do to the federal deficit. 
 
 But the draft shows that Republicans are sticking closely to previous plans floated by Ryan and Price in crafting their Obamacare repeal package. 
 
 “Obamacare has failed," said HHS spokesperson Caitlin Oakley. "We welcome any and all efforts to repeal and replace it with real solutions that put patients first and back in charge of their health care rather than government bureaucrats in Washington, D.C.” 
 
 Other changes proposed by Republicans align with previous ideas for strengthening the individual insurance market, which has been unstable under Obamacare with rising premiums and dwindling competition. For example, the legislation would allow insurers to charge older customers up to five times as much as their younger counterparts. Currently, they can only charge them three times as much in premiums. The insurers have been pushing for that change. 
 
 The proposal also includes penalties for individuals who fail to maintain coverage continuously. If their coverage lapses and they decide to re-enroll, they would have to pay a 30 percent boost in premiums for a year. Like the unpopular individual mandate, that penalty is designed to discourage individuals from waiting until they get sick to get coverage. 
 
 Republicans have vowed to dismantle Obamacare ever since it passed with only Democratic votes in 2010. But reaching agreement on what should come next has proven difficult since they gained full control of Congress and the White House. 
 
 Recent polling has shown that Obamacare is increasingly popular. Supporters of the health care law have been turning out by the hundreds at town hall meetings across the country to demand that Republicans answer questions about what’s going to happen to the 20 million individual who have gained coverage under Obamacare. 
 
 According to the latest Kaiser Family Foundation tracking poll, released Friday morning, the public now views the Affordable Care Act more favorably than it has since the summer of its enactment. Some 48 percent view the law favorably — up from 43 percent in December. About 42 percent have an unfavorable view of the ACA — down from 46 percent in December. The pollsters say Independents are mostly responsible for the shift. A separate poll by the Pew Research Center found 54 percent approve of the health care law — the highest scores for Obamacare in the poll's history. Meanwhile, 43 percent said they disapprove. 
 
 
 
 CLARIFICATION: This story has been updated with the timing of the House GOP's plans for releasing a health care bill. ||||| Politico has obtained a leaked draft of a Republican replacement plan for Obamacare. The plan may be somewhat outdated already — it is two weeks old, per its time stamp, and Republicans have been working hard on their proposal in the meantime — but it almost certainly reveals an important shift from earlier GOP plans. 
 
 In broad strokes, the draft bill hews closely to ideas outlined by House Speaker Paul Ryan and Health and Human Services Secretary Tom Price. Compared with the Affordable Care Act, this proposal would generally be worse for people who are poorer and sicker — but better for those who are higher-income and healthy. Democrats will near certainly blast this proposal as bad for the 21 million Americans who rely on Obamacare for coverage. 
 
 But buried in the details of the 106-page document is actually a bit of an evolution on the part of the Republican Party. I’ve spent a lot of time reading Republican replacement plans for Obamacare, and this is definitely a more consumer-friendly version of their ideas than those introduced in the past. 
 
 This bill — and we don’t know right now which committee it came from or which legislators back it — has more generous financial support for those who buy their own plans, for example, and lower penalties for Americans who do not maintain continuous insurance coverage. 
 
 Republicans seem pretty wedded to the reform concepts they outlined years ago. This includes things like age-based tax credits, a continuous coverage provision instead of an individual mandate, and a significant scaling back of the Medicaid expansion. 
 
 But Republicans seem open to changing the details of how those provisions are implemented. What this means for patients will, in a lot of ways, come down to the smaller decisions: how big those age-based tax credits are, for example, or how much an individual who doesn’t maintain continuous coverage could be penalized. On that front, there really is a notable shift on the part of Republicans toward a plan that would be more financially generous. 
 
 The leaked Republican plan restricts — but doesn’t ban — discriminating against people with preexisting conditions 
 
 The leaked Republican draft, like Obamacare, requires insurance plans to offer coverage to all patients regardless of how sick they are. But the leaked plan, unlike Obamacare, would let insurers charge sick people more if they did not maintain “continuous coverage.” 
 
 This continuous coverage policy has shown up a lot in Republican replacement plans. It was part of Speaker Ryan’s A Better Way proposal and Rep. Price’s Empowering Patients First Act. 
 
 Here’s how it works: If a cancer patient goes straight from insurance at work to her own policy, her insurer has to charge her a standard rate — it can’t take the cost of her condition into account. 
 
 But if she had a lapse in coverage — perhaps she couldn’t afford a new plan between jobs — and went to the individual market later, insurers could charge her up to 130 percent of the standard rate for her first year of coverage. She would have to pay that higher rate for a full year before getting access to the normal rate. 
 
 This is a notably less harsh penalty than the one that Price suggested in his 2015 Empowering Patients First Act. In that bill, he would have allowed insurers to charge people like this 150 percent of the standard premium for 18 months. 
 
 The leaked draft does have a safety net for people who can’t afford to buy this more expensive coverage. It would invest $100 billion over 10 years into funding state efforts to cover “high-risk individuals” or to “help stabilize premiums for health insurance coverage in the individual market.” 
 
 States could presumably put this money toward high-risk pools, an idea that shows up in many other conservative proposals, although in the leaked draft they wouldn’t necessary have to. 
 
 This is significantly more generous than other Republican proposals for how much to spend on the especially high-cost patients. Ryan’s plan, for example, would put $25 billion toward the high-risk pools over a decade ($2.5 billion per year) and keep them running indefinitely. The Price plan envisions only $3 billion for high risk pools over three years. 
 
 The leaked bill would generally be worse for people who are poorer and sicker, but better for attracting enrollees who are young and healthy. Perhaps most notably, however, the bill is generally more generous and consumer-friendly to all enrollees than previous policy proposals. 
 
 Still, it’s unclear whether this would actually meet the needs of Americans with especially costly conditions. I’ve had some conservative health policy experts suggest to me that it would take about $25 billion per year to make high-risk pools function properly. And again, the funds in this leaked bill are not earmarked just for high-risk pools, and could be spent in other ways — meaning the funding could be much lower than the numbers outlined here. 
 
 The leaked draft makes insurance better for people who are young and healthy. It makes insurance worse for people who are old and sick. 
 
 One constant Obamacare gripe from Republicans is that the health care law mandates too big of a benefit package. This drives up premiums, they argue, and scares off some healthy and young enrollees who want to buy a skimpier plan. 
 
 There is some truth to this argument. Obamacare’s marketplaces have struggled to attract young adults at the level the White House had initially hoped. (The Obama administration originally said it wanted one-third of the marketplace to be people between the ages of 18 and 34, but right now it’s only about a quarter.) 
 
 The leaked draft makes the individual market more advantageous for healthier people. It eliminates the essential health benefits package, which mandated that all insurers cover a set of 10 different types of care, including maternity services and pediatric care. The leaked draft would allow states to decide which benefits are “essential.” 
 
 Some states might choose skimpier benefit packages that would allow insurers to cut certain benefits they no longer want to cover — they could stop covering maternity benefits, for example, to make their plans less attractive to women who plan to become pregnant. This would likely benefit healthy people, who generally want less robust coverage at a cheaper price. But it’ll send the cost of more comprehensive plans — the plans sicker people need — skyrocketing. And it could leave someone who wants, say, health insurance to cover her maternity costs completely out of luck. 
 
 There are other ways the leaked draft makes insurance better for young people too: by letting insurance plans charge them lower rates. 
 
 It does this by allowing insurers to charge their oldest enrollees as much as they want. Right now insurers can only charge the oldest enrollees three times as much as the youngest — that constrains prices for patients in their 50s and 60s. 
 
 Eliminating this regulation “increases the overall number of people with coverage, but older people end up falling out of the market as premiums rise,” says Christine Eibner, an economist with the RAND Corporation who has modeled similar changes to Obamacare’s age-rating provisions. 
 
 And while young people might have cheaper premiums and an easier ability to enroll, older Americans could struggle to purchase coverage in this market, where their costs would rise. These are people who tend to have more urgent health care needs and could be in a worse position without health care than a young adult might be. 
 
 This worries some Obamacare supporters, who say the goal of insurance reform isn’t just to expand coverage — it’s to expand coverage for people who really need health care. 
 
 “If you replace a 60-year-old with a 20-year-old, that doesn’t change the number of people covered, but it changes the value of the coverage and of the program,” says Jonathan Gruber, the MIT economist who helped the White House model the economic effects of Obamacare. 
 
 The leaked draft would provide tax credits, but they would help older (and likely richer) people more 
 
 The leaked draft, like Obamacare, envisions that Americans will use tax credits to purchase individual health insurance, but the structure of the tax credits is very different. 
 
 Obamacare’s tax credits are based on income, with those who earn less getting more help. The leaked draft’s tax credits would only be based on age, giving more help to those who are older (and who will presumably be charged higher premiums). The tax credits outlined in the bill are as follows: 
 
 $2,000 for those under 30 
 
 $2,500 for those between 30 and 40 
 
 $3,000 for those between 40 and 50 
 
 $3,500 for those between 50 and 60 
 
 $4,000 for those over 60 
 
 This means that Bill Gates would qualify for the largest tax credit simply because he is 61 years old. Under the Empowering Patients bill, Gates’s net worth of $83 billion — presumably enough to purchase health coverage — would do nothing to disqualify him. Under Obamacare, he gets no help. 
 
 Conversely, a 23-year-old with little income who has health problems gets minimal help under Price’s plan — despite the fact that she needs support much more than Gates does. 
 
 But what was especially notable to me about these credits is that they’re significantly more generous than the ones that Price proposed in his 2015 Empowering Patients First Act. He suggested the following tax credits: 
 
 $900 for children under 18 
 
 $1,200 for those between 18 and 35 
 
 $2,100 for those between 36 and 50 
 
 $3,000 for those 51 and older 
 
 The plans under the leaked proposal would almost certainly be cheaper because they wouldn’t have to cover so many benefits. A 55-year-old under this health care system, for example, might find lower premiums for plans that cover fewer benefits. But it’s also true that the plans that do offer comprehensive benefits would likely prove financially out of reach for many. 
 
 The leaked draft repeals Medicaid expansion without any replacement 
 
 Under this proposal, states could continue to cover the Medicaid expansion population — but they would get significantly less federal funding, which could push some states to drop out of the program entirely. 
 
 Separate from the Affordable Care Act, the leaked draft suggests dramatically cutting funding for the Medicaid program entirely. Right now states and the federal government split Medicare patients’ bills. Each pays a certain percentage of the costs. The commitment to paying those medical bills is essentially unlimited: The two governments will pay whatever bills rack up. 
 
 The leaked draft, however, would change that entirely. It suggests a “per capita cap” model, where each state would get a set amount for the number of people it was expected to enroll. If states were able to keep costs low, they might even be able to keep some of that money. But states could get into trouble if they found that they were spending more per person than their federal funding expected. They might need to cut back on the benefits the program offers, for example, or cover fewer people to make the numbers work. 
 
 You can read more about how a proposal like this works in a longer explainer here. 
 
 It’s very easy to see the ideas in this draft changing a lot in the coming weeks and months. Republican governors like Ohio’s John Kasich and Michigan’s Rick Snyder have begun to advocate for keeping Medicaid expansion, which covers thousands in their home states. Kasich is meeting with President Trump today and will certainly press the issue, and dozens of governors will be in Washington this weekend for the National Governors Association conference. You can bet this is a section they care about a lot — and will try to change significantly. 
 
 The leaked draft has a new tax on high-cost health insurance plans that employers offer 
 
 Most of the changes in the leaked draft have to do with people who get insurance through Medicaid or on the marketplaces. But there is one important change the plan would make to employer-sponsored insurance: It would cap the tax exclusion for employer-sponsored coverage. 
 
 The health insurance tax break is the biggest in the federal budget; the government loses out on $260 billion annually by not taxing health benefits. And economists across the political spectrum agree that we should eliminate or at least reduce this tax break, which currently gives those with jobs a huge discount on their coverage — and an incentive to buy more coverage than they actually need. 
 
 The leaked draft proposes taxing any employer-sponsored coverage above the 90th percentile of current premiums. If this sounds familiar, it’s because Obamacare had something awfully similar: the “Cadillac tax,” which was a 40 percent excise tax on especially high-cost health care plans. 
 
 As popular as this provision will be with economists, you can bet that the public will hate it, as it would make some health plans significantly more expensive. There is already a lobbying campaign to kill this provision — even before Republicans have officially proposed the idea. 
 
 “During meetings on Capitol Hill last week, there were acknowledgements of the role of the group market and a commitment to not disrupting that,” says Ed Fensholt, a senior vice president at the health brokerage firm Lockton. “I think there was, however, a lack of understanding that certain things they do might have a disruptive effect.” 
 
 Watch: Obamacare in Trump country ||||| A doctor discusses medical treatment with a patient. (Joe Raedle/Getty Images) 
 
 The public perception of President Barack Obama's health care law is becoming more positive as the Affordable Care Act faces threats of repeal, according to a new poll. 
 
 The favorability ratings are at their highest recorded levels since the summer of 2010. The poll, by the Kaiser Family Foundation, has been conducted more than 60 times. 
 
 To assemble the data researchers surveyed 1,160 adults by phone in mid-February about their opinions regarding different portions of the law, sometimes called Obamacare. They found that 48 percent of those surveyed now have favorable views of the Affordable Care Act – up from 43 percent in December. In comparison, 42 percent of those surveyed had an unfavorable view of Obamacare, down from 46 percent in the December poll. 
 
 The shift was driven largely by people who identified as being politically independent, and the unfavorability rates did not fall below their lowest levels, recorded in July 2010, when they were at 35 percent. 
 
 Prior to the most recent poll, the public's views on the law were more unfavorable than favorable, even as its major provisions became enacted and about 21 million people gained coverage or more robust health insurance. 
 
 Republicans in Congress and President Donald Trump have long vowed to undo the Affordable Care Act, though they haven't said what they would replace it with. Democrats have seized on this lack of unity, holding events across the country to tell people about the dangers of repealing the law. During the past week activists and constituents have been protesting repeal at Republican town halls. 
 
 In watching lawmakers talk about repealing the law, Americans reported mixed emotions: 56 percent are worried, 53 percent are hopeful, 45 percent are confused, 38 percent are angry and 33 percent are enthusiastic. Nearly half of those surveyed said that they feared someone in their family would lose coverage if the law is repealed and replaced. 
 
 Despite the change in overall attitudes, the survey reveals people remain split on what should happen to the law next. Most of those who favor repeal, however, would like to see a replacement plan first. 
 
 The survey also examined people’s views on Medicaid expansion, which was a provision of the law that allowed states to provide no- or low-cost coverage to low-income residents. Republicans in Congress have been discussing what to do about this portion of the law, though GOP governors have cautioned that repealing expansion would be damaging to their constituents. 
 
 The majority of respondents, regardless of political leanings, said it was important that a replacement plan continues to provide federal funds to the 31 states and District of Columbia that expanded the program under the Affordable Care Act. 
 
 Republicans have offered other solutions for Medicaid, including a proposal that would allow funds to be distributed through block grants – which may limit funding but gives states more flexibility about what programs to prioritize and which people to cover – or change it to a per-capita allotment system. 
 
 Most respondents surveyed – 65 percent – reported that they would rather Medicaid continue as it is today than either of the offered alternatives to the current federal funding structure. Under the current structure, the federal government matches state spending but sets specific standards and benefits for states. 
 
 
 
 Corrected on Feb. 24, 2017 : A previous version of this story misstated the law's past popularity.
– House Republicans want to get rid of the Affordable Care Act's subsidies, Medicaid expansion, and individual mandate, according to a leaked draft of a bill to repeal ObamaCare. The bill, which was obtained by Politico, would give money to states to cover some people with pre-existing conditions and replace subsidies with tax credits based on age rather than income. As it stands, people under 30 would get a $2,000 tax credit, while people over 60 would get $4,000. Vox, which has an in-depth explanation of the bill, reports that sets up the possibility that tax credits would mostly benefit richer Americans, who are typically older. But insurance, as laid out in the bill, would overall be better for younger, healthier people than older people. And it would still be possible to refuse coverage to people with pre-existing conditions. House Republicans plan to pay for their healthcare plan by restricting tax breaks on employer health plans. This is a version of ObamaCare's "Cadillac tax," which was opposed by businesses, unions—and Republicans. The draft bill is likely to change as it passes through various committees. Meanwhile, ObamaCare is more popular than it's been in seven years. A survey released Friday shows 48% have a favorable view of the ACA compared to 42% with a negative view, US News reports. That's a sizable turn around from December, when only 43% viewed it favorably and 46% viewed it negatively. According to USA Today, nearly 50% of people polled were worried a family member would lose coverage if the ACA is repealed.