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Uncertainty surrounds health care these days.

As Gov. Chris Sununu delivered his budget address last week, he offered few clues on the future of the states insurance exchanges and expanded Medicaid program. Thats largely because New Hampshire lawmakers and health officials are waiting to see what happens at the federal level.

President Donald Trump and Congressional Republicans have made clear they would like to repeal and replace the Affordable Care Act but have not yet outlined how exactly they would do so.

National reports illustrate deep internal divisions among Congressional Republicans over how to proceed the partys conservative wing is in favor of quick repeal, while more moderate Republicans are urging caution.

A straight repeal would suddenly leave 22 million Americans without insurance.

Heres a breakdown of some of the plans currently being floated in Washington.

This plan is seen as a more moderate replacement option. The plan requires insurance carriers to cover all patients, no matter how sick they are. But it contains a requirement making patients maintain continuous coverage and allows insurers to charge people more if they dont.

Better Way would allow insurers to choose which benefits they want to cover and drop ones they dont. This is widely seen as more advantageous for healthier people who want cheaper insurance that doesnt cover everything, but its a disadvantage for sick people who can currently buy plans that cover more conditions under the Affordable Care Act.

Better Way also allows insurers to charge young people lower rates, and would allow them to charge their oldest enrollees five times as much as young ones.

To put this in dollar amounts, the nonpartisan RAND Corp. estimated premiums for a 24-year-old would decrease from $2,800 to $2,100 annually, while premiums for a 64-year-old would rise from $8,500 to $10,600.

The plan would put $25 billion toward so-called high-risk insurance pools over the next decade. These pools are designed to cover the sickest and costliest patients, taking them out of the overall health insurance pool and thereby lowering costs for healthier people.

When it comes to Medicaid Expansion, the plan proposes giving more control to states by providing block grants or per capita allotments and allowing states to decide how to spend it.

More conservative Republicans think Ryans replacement plan looks too much like the ACA.

One of the main features of this plan is fixed tax credits, which people can use to buy insurance on private markets. Each person would receive a $1,200 tax credit per year, no matter a persons income bracket. However, that amount rises as people age; for instance, people 51 and older get $3,000 per year.

The plan also favors expanding high-deductible health savings accounts, nontaxable accounts that people can put money in for health care costs.

There are a lot of similarities between Ryans plan and the one proposed by Health and Human Services Secretary Tom Price a few years ago, including letting insurers drop patients if they dont maintain continuous coverage, and making insurance cheaper for young and healthy people and more costly for older and sicker people.

There are also significant ways they differ. For instance, Prices plan would do away with expanded Medicaid without a replacement option, which could end insurance coverage for more than 15 million Americans enrolled in the program.

While it would create a high-risk pool for sick patients, it would invest much less money into the pool than Ryans plan $3 billion versus $25 billion over 10 years.

Under Prices plan, insurance carriers could charge older customers as much as they want.

This legislation, recently proposed by Republican Sens. Susan Collins of Maine and Bill Cassidy of Louisiana, would allow states to keep the Affordable Care Act as an option.

The Patient Freedom Act would repeal the Affordable Care Acts mandates including the individual mandate, employer mandate and benefit mandates to allow consumers to choose plans that cover fewer conditions and cost less.

It keeps prohibitions on annual and lifetime limits, bars insurance companies from refusing to cover people with pre-existing conditions and keeps a popular provision of the law that allows young adults to stay on their parents insurance until age 26.

The bill gives states a lot of freedom to decide how they want to proceed with setting up their health care programs. States can either re-implement the Affordable Care Act or choose a new market-based exchange where they would still receive federal dollars and tax credits that would go directly to patients health savings accounts.

The third option the bill outlines is for states is to design and regulate a new insurance exchange without any assistance from the federal government.

(Ella Nilsen can be reached at 369-3322, enilsen@cmonitor.com or on Twitter @ella_nilsen.)

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Three Republican plans that could replace the Affordable Care Act - Concord Monitor

Russian servicemen equip an Iskander tactical missile system at the Army-2015 international military-technical forum in Kubinka, outside Moscow, Russia, June 17, 2015. Russia on Tuesday was accused of violating a nuclear arms treaty with the U.S. for deploying a ground-based missile system similar to the Iskander. Photo By Sergei Karpukhin/Reuters

Republicans on Thursday introduced bills that would take steps to hold Russia in compliance with a nuclear arms treaty formed with the U.S. in 1987.

The billscame two days after The New York Times disclosed that Russia had violated the treaty by deploying a ground-based missile with nuclear capabilities.

U.S. intelligence officials knew of the missile, which was classified and not made public until the Times reported the story on Tuesday. The weapon was identified as a ground-based cruise missile, a type banned under the Intermediate Range Nuclear (INF) Forces Treaty of 1987.

In response to this weeks findings, Republicans on Thursday introduced legislative actions in the House and Senate to push back against the violations. Language in the Senate bill points to Russias non-compliantactions on the INF Treaty dating back to 2008. If enacted in its current form, the bill would allow Congress to declare Russia in material breach of the treatyand lay the legislative grounds for the United States to eventually develop its own ground-launched intermediate cruise missiles capability.

The INF treaty required the U.S. and the Soviet Union to eliminate ground-launched ballistic and cruise missiles with ranges between 500 and 5,000 kilometers, according to the Arms Control Association. Former President Barack Obamas administration also accused Russia of testing a similar-style weapon in 2014. An intelligence report cited by the Times indicated the missile identified may have been an SSC-8.

The treaty marked the first time the superpowers had agreed to reduce their nuclear arsenals, eliminate an entire category of nuclear weapons, and utilize extensive on-site inspections for verification, according to the Arms Control Association. It also led to both countries destroying more than 2,000 other nuclear weapons over a four-year period.

Both the House and Senate bills, called the Intermediate-Range Forces Treaty (INF) Preservation Act, were introduced on Thursday with the purpose of bringing Russia into compliance with the 1987 treaty. The bills also raise the possibility of increasing the number of nuclear arms in Europe following significant reductions in the U.S. arsenal that began decades ago.

The Senate bill was referred to the Committee on Foreign Relations for review, though it remained unclear whether the legislative actions would receive broad support in the Republican-controlled Congress.

If Russia is going to test and deploy intermediate range cruise missiles, then logic dictates that we respond, Sen. Tom Cotton (R-Arkansas) who co-sponsored the bill with Sens. Marco Rubio (R-Florida) and Ron Johnson (R-Wisconsin), said in a statement. Pleading with the Russian regime to uphold its treaty obligations wont bring it into compliance, but strengthening our nuclear forces in Europe very well might. Were offering this legislation so we can finally put clear, firm boundaries on Russias unchecked aggression.

U.S. President Ronald Reagan, right, and Soviet President Mikhail Gorbachev sign the Intermediate-Range Nuclear Forces (INF) treaty at the White House, on December 8, 1987. Photo via Reuters

The report of the missile deployment comes after several tumultuous years of relations between the two countries and as President Donald Trump has sent mixed signals over his administrations intentions toward Russia, which has made several incendiary moves in recent years including the annexation of the Crimean peninsula in Ukraine.

Russian and U.S. officials met in Geneva in November to discuss accusations about Russian compliance with the INF treaty.

Few additional details are known about the missile loosely identified this week as a SSC-8, according to interviews conducted by the PBS NewsHour with nuclear arms experts, political scientists and think tanks.

But Michael Kofman, a research scientist and former fellow at the Woodrow Wilson International Center, said a ground-based cruise missile would be launched out of a truck-like transporter erector launcher. The missile identified this week was thought to be located among two battalions in Russia.

A standard missile brigade fields 12 launchers and about 51 vehicles total, Kofman said in an email. The range of this missile by definition would have to be over 500 kilometers to be in violation of the INF, but given known cruise missile designs it is likely not more than a few thousand kilometers in range.

Daryl Kimball, executive director of the Arms Control Association, said unlike ballistic missiles, which reach high altitudes, cruise missile are powered, guided and maneuverable missiles that follow a lower flight path.

Thomas Karako, a senior fellow with the International Security Program and the director of the Missile Defense Project at the Center for Strategic and International Studies, said the bills introduced on Thursday may have been a way for Republicans to convey that they want to get Russia back in compliance so here are the kind of things that we propose doing.

Congress is taking this very seriously and should be taking this very seriously, he said.

Harvard University professor Matthew Bunn, a former adviser to the White House Office of Science and Technology Policy and a nuclear expert, said the Pentagon has a range of options for responding.

I continue to believe that the U.S. will be working with NATO allies, he said. So that we can sustain the treaty.

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Republican bills counter Russia's apparent violation of nuclear arms treaty - PBS NewsHour

Upstate NY Republican confronts jeers at town hall meetings News & Observer Republican Rep. Thomas Reed was greeted by scores of boisterous protesters at town hall meetings in western New York. The crowd at a senior center in North Harmony was so large that Reed's meeting was moved outside on a sunny Saturday morning. and more »

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Upstate NY Republican confronts jeers at town hall meetings - News & Observer

Reprinted with permission from Alternet.

Almost all congressional Republicans are scared of facing voters in town hall meetings over the long Presidents Day weekend. Only 19 representatives and senatorsa tiny numberwill hold town meetings during the first recess of the current session of Congress, reports the Town Hall Project. But the groups listing of these democratic mainstays barely tells the story.

An eye-opening Washington Post accountrevealed that Republican officeholders have been canceling planned town halls because they dont want to face critics upset that they may soon lose their health insurance or see an increase in costs as the GOP plans to undermine Obamacare. Even worse, they dont want organized progressive groups to show up with posters, video cameras, and a determination to challenge them in public while posting the confrontations on YouTube:

According to the Town Hall Project, which collates information about public town halls, there are no availabilities in Utahwhere every federal officeholder is a Republicanover the coming week. Thats not a fluke. Just 19 Republican members of Congress have scheduled traditional town halls over the weeklong recess. Several more, like Senate Majority Leader Mitch McConnell (R-KY.), have listed ticketed events or office hours; a few more have announced tele-town halls, which allow constituents to lob questions without risking a YouTube moment.

This cowardly response is nothing new from immoderate Republicans; its in line with their partisan ethic that anything goes to win, except playing fair. They cannot win in many states without gerrymandering federal and state districts, which allowed them to seize power after the 2010 Census. They cannot win widely in high turnout elections, hence their efforts to limit participation by creating barriers like new voter ID laws or restricting voting options favored by critics, like early voting on weekends.

Their partisan cowardice goes further by not wanting to reveal who is funding negative attack ads, thus they encourage super PACs to throw mud because they do not disclose donors. In contrast, they never stand up and say all sides should put forth their best ideas and allow citizens to decide, live with that verdict and fight another day. And in 2017, a new twist has emerged: the party that would stamp on others is hiding from voters.

Indeed, Republicans dont like it when the tables are turned on themthat is, when their town hall meetings are not filled with angry Tea Partiers but with aggrieved citizens from their districts and organized progressives.

Since Republicans took control of the House six years ago, helped by angry, viral town halls that embarrassed incumbent Democrats, big public meetings have become rarer and workarounds like the tele-town hall more common, reported the Post. But in the past week, as Indivisible, Organizing for America, and other progressive groups have become more open about demanding town halls, some Republicans have become bolder about shutting them down.

A few are even admitting this is exactly whats going on.

In a letter to constituents first shared by the Knoxville News Sentinel, Rep. John J. Duncan Jr. (R-TN) said that he valued being accessible but would not indulge protesters by holding a public event, noted the Post article. I am not going to hold town hall meetings in this atmosphere, because they would very quickly turn into shouting opportunities for extremists, kooks and radicals, Duncan said. Also, I do not intend to give more publicity to those on the far left who have somuch hatred, anger and frustration in them.I have never seen somany more sore losers asthere are today.

Needless to say, these Republicans are fine when their own propagandists are doing the yelling, namely those in right-wing media and related GOP groups, who conveniently ignore that progressives and others are doing what Tea Partiers have been doing for many years.

The National Republican Congressional Committee denounced a top-down effort to manufacture controversy, according to the Washington Post. Fox and Friends, a cable news morning show that President Trump watches regularly (and praised in Thursdays news conference), has frequently highlighted violent protests and hyped reports that some protesters are being paid.

Such shamelessness is nothing new in Republican circles. It may even be part of their twisted political DNAthe attitude that everything they do is magically patriotic, all-American and justified. The truth is congressional Republicans are running away from the voters in their districts who have ample reasons to be angered at the GOPs uncritical embrace of Trump and the far rights extremist economic and cultural agenda.

Whats the word for elected officeholders not standing by their beliefs in public and facing voters in their districts? Cowardice, plain and simple, and thats just the start.

IMAGE: Angry protesters outside Republican Rep. Tom Reeds town hall in upstate North Harmony, N.Y. on Saturday morning, February 18, 2017, one of only 19 held by Republican House or Senate members over Presidents Day weekend /New York Times video

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Cowardly Republican Legislators Canceling Weekend Town Hall Meetings - The National Memo (blog)

Los Angeles Times

Republican leaders tire of Trump drama, but GOP activists close ranks Sacramento Bee The chaos of President Donald Trump's White House has Republican leaders scrambling to defend what they hope will soon be a functional administration. But cracks in that resolve are starting to show amid a seemingly endless series of self-inflicted ... Republicans in Congress gambled on Trump and won. Here's why they're worried nowLos Angeles Times Republicans hang on for Donald Trump's wild rideCNN Republicans Slow to Tackle Trump's Big IssuesFox Business Yahoo Finance -The Atlantic -TIME all 376 news articles »

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Republican leaders tire of Trump drama, but GOP activists close ranks - Sacramento Bee