After voting unsuccessfully dozens of times over the years to repeal Obamacare, the Republican majority in the US House has produced a bill that may lead to the end of President Obama's signature accomplishment.
The 122-page American Health Care Act (AHCA) keeps several of the most popular aspects of Obamacare. People cannot be denied healthcare because of a pre-existing medical condition. Parents can keep their adult children in their insurance until their children turn 26.
Even one change is not a complete change. The "individual mandate", the provision which requires people buy healthcare coverage or face a fine, is gone in the GOP bill. It's replaced with a penalty for those who drop coverage and then re-enroll. A one-year 30-percent increase in the cost it the proposed penalty for those who yo-yo out and then back into coverage.
The change that may concern state government in New York is over Medicaid. Under Obamacare, a number of states including New York, added people to the Medcaid roles thanks to the federal government reimbursing 90 percent of those costs.
Republican Congressman Chris Collins, who sits on the House Energy and Commerce Bill which co-wrote AHCA, says by 2020, states will face drastically different reimbursement.
"The federal government will reimburse at 50-percent which is what we reimburse all other Medicaid recipients," says Collins.
When it was pointed out the change could cost state government billions of dollars, Collins replied, "I can’t tell you how many dollars it is. But New York is the state that spends almost as much money (on Medicaid) with 20-million people as Texas and California do with 60-million people.”
Brian Higgins, Democratic Congressman from Buffalo, panned the GOP bill outright, "This plan gives all the power back to the insurance company and it screws the little guy…and particularly people here in Buffalo and western New York.”
Republicans know they have a battle on their hands to get their bill passed.
"Oh, it won't be easy," says Collins.