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Speaker of the House Paul Ryan (R-WI) reads from a list of states with increasing health insurance premiums during his weekly news conference in the Capitol Visitors Center at the U.S. Capitol on Jan. 12, 2017 in Washington, D.C. Photo By Chip Somodevilla/Getty Images

WASHINGTON A formal draft of the House Republican plan to repeal and replace the Affordable Care Act leaked out on Friday.

The final version is likely to be different how much different, its hard to say. The draft obtained by Politico is dated two weeks ago, and rumors have been swirling here that Republicans received an unfavorable analysis from the Congressional Budget Office, the official scorekeepers on the cost and coverage implications of legislation.

But this is nonetheless an important milestone real legislative text, prepared with an eye toward the complex parliamentary procedures needed to pass ACA repeal with only Republican votes, and presumably with the endorsement of House leadership.

Much attention will be paid to the proposed tax credits offered for people to buy health insurance and the changes to the tax treatment of employer-based insurance. Here are five provisions with big implications for health and medicine. It would dramatically overhaul Medicaid.

The bill would phase out by 2020 the Medicaid expansion that has covered millions of people under Obamacare. Instead, states would begin to receive a set dollar amount for each person covered by the program with variations based on health status; more money would be allocated for the disabled a change from the open-ended entitlement the program is now.

READ NEXT: A boy who cant speak is on Medicaid. What happens to him if he is cut out?

These proposals, long a goal of the GOP, have spurred a number of concerns. People with complex medical needs worry that, if spending is capped and states have more flexibility to decide what to cover, they could be at risk. There appear to be very few exclusions from the spending caps some have theorized that if the plan exempted certain services from the caps, that could help mitigate the risks for high-cost patients.

The changes could also make it more difficult for the program to afford new breakthrough treatments, a challenge that the current iteration of Medicaid has already faced with the expensive hepatitis C drugs.

It would repeal Obamacares requirements for what health insurance must cover.

The legislation would repeal the ACAs essential health benefits requirements, which mandated that health plans cover 10 categories of health care services. It would instead leave decisions about what coverage to require to the states, starting in 2020.

Among the services that the law required plans to cover were mental health and substance abuse treatment. In the midst of the opioid crisis, recovery advocates in Washington had been hoping to save that provision. It appears that that decision would now be in state officials hands, and the fear is plans might look to limit that coverage because people with addiction issues are expensive to treat and therefore cover.

READ NEXT: Medicaid could struggle to cover breakthrough treatments through GOPs plan

It would repeal the Prevention and Public Health Fund.

The bill would repeal this funding stream, intended to support various prevention and public health activities, in 2019. Congress initially provided $15 billion over the funds first 10 years, and it was eventually suppose to increase to $2 billion per year in perpetuity.

The fund has been at perennial risk since its passage in 2010, pilfered at times for other programs, but it nonetheless remains an important source of public health funding. It has become an essential part of the Centers for Disease Control and Preventions budget accounting for 12 percent of the agencys funding by some estimates and there would be no obvious replacement for those dollars without further congressional action.

It would repeal the tax on pharmaceutical manufacturers.

The drug industry has not agitated to have its manufacturer tax repealed, in the same way that the medical device and health insurance industries have. But the Republican bill would nonetheless nix the tax starting in 2017. The industry still had $4 billion to left to pay in 2017, $4.1 billion in 2018, and $2.8 billion per year after that.

The taxes on medical devices, health insurance plans, and even tanning beds would also be repealed. Those revenue streams help to cover the cost of the ACA. Republicans are instead proposing changing the tax treatment of employer-based health insurance, which is currently not taxed, to pay for their plan. It is an idea popular with economists, but politically perilous. Major employer groups are already aligning against it.

It loosens restrictions on health plans ability to charge older people more.

One thing the bill doesnt do is repeal the ACA provision that prohibits health plans from discriminating against people with preexisting conditions. That may be because it would be hard to justify under the procedural rules that Republicans need to use to pass the bill plus that policy is among the laws most popular elements and even President Trump has said it should be maintained.

But another key insurance reform meant to protect sicker people takes a hit: The GOP bill would allow insurers to charge older people five times more than younger people; the ACA had limited the difference to three times as much. The powerful AARP is already mobilizing against such a change, long expected to be part of the plan.

The bill appears to try to mitigate that change by basing its tax credits for purchasing insurance on age: Older people would receive a bigger tax credit.

Is that sufficient to keep people covered, as Trump and other Republicans have pledged to do? Thats one of the questions that the scorekeepers at the CBO will be expected to answer.

This article is reproduced with permission from STAT. It was first published on Feb. 24, 2017. Find the original story here.

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Five takeaways from the leaked Republican bill to repeal Obamacare - PBS NewsHour

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I think we need to pay attention to what Steve Bannon means by deconstructing the government (Bannon: Trump administration is in unending battle for deconstruction of the administrative state, Nation, Feb. 24). Conservative Republicans have always pushed for less government, but always in a framework that respects the priority of the actual words of the Constitution. Deconstruction in literature and philosophy asserts that a piece of writing does not have just one meaning and that the actual meaning depends on the reader. Bannon wants to be the person who interprets that meaning. He wants to be the reader. This flies in the face of the usual Republican philosophy of strict constructionism and leads to a situation where anything can be legal as long as the current administration interprets it that way. It means the end of a nation of laws, not men.

Jack Finn

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What kind of Republican is Steve Bannon, anyway? - The Boston Globe

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CA Senate returns amid drama over ejection of Republican lawmaker Sacramento Bee The incident turned Nguyen into a hero of sorts for the state Republican party, which honored her and played a video of the floor session at its annual convention in Sacramento over the weekend. Some supporters wore I stand with Janet stickers. Sen. and more »

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LAS VEGAS (JTA) Republican Jews have President Donald Trump to thank for their partys renewed dominance of Washington politics. So what do they think of him?

Marlyn Appelbaum paused to contemplate the question at the opening of the Republican Jewish Coalitions confab at the Venetian resort hotel in Las Vegas Friday evening.Then, she avoided mentioning the president.

My biggest thing is pro-Israel, said Appelbaum, the head ofa teacher training institute in Sugar Land, Texas. I was real upset at the last eight years. I think things for Israel are going to turn around.

Her answer capturedthe vibeat the RJCs annual two-day Leadership Meeting. Amid giddy celebration of the end of the Obama years and the advent of a new Republican administration, RJC officials and members seemed to make an effortto get excited about Trump, with whom their group has a fraught history.

By contrast, Vice President Mike Pence, one of the pro-Israel communitys closest friends, was greeted effusively at the event, where headdressed the crowd.

For the first time in RJC history we have a sitting Republican [vice president] sitting with us for our Shabbat dinner! RJC director Epsteinannounced ahead ofPences speech.The crowd erupted in applause.

And a Republican president who is going to make our country great again! Epstein added. Only acouple tables in the corner clapped.

Still,Make America Great Again kippahsdotted the Venetians byways, and Elliot Lauer, a board member perhaps best known as Jonathan Pollards lawyer, delivered a dvar Torah Friday evening in which he likenedTrumps victory to the triumph of the Jews in ancient Persia celebrated on Purim.

Asked about Trump, RJC members clad in bespoke suits and flowing gowns highlighted his political effectiveness.

He did say things that were offensive, said Robert Lewit, a retired psychiatrist from Florida who in the Republican primaries supported Marco Rubio, his states U.S. senator.But hes innately a brilliant politician, making immigration an issue, advocating for a U.S. economic revival.

Though unimpressed by Trumps star turn onThe Apprentice reality show, Lewits wife, Jane, said, No one saw what he saw: the forgotten man, a referenceto Trumps appeal to working and middle class Americans. In any case, its better than what was. I happen to have had a total antipathy for our last president, and everything he stood for.

It has been a rocky road for the RJC and Trump.At the groups presidential candidates forum in December 2015, Trump mocked the wealthy Jewish donors by saying he too was richand so immune to their purchasing power. He also said he would be neutral on brokering Israeli-Palestinian peace and refused to recognize Jerusalem as Israels capital.

Then there were Trumps affronts tominorities, like Muslims and Hispanics, which did not sit well with a Republican constituency that has in recent years spearheaded calls for the party to be more inclusive. And when Trump appeared last spring hesitant to disavow his burgeoning support from the alt-right, a loose grouping of anti-establishment conservatives that includes within its ranks unabashed anti-Semites, the RJC went dark.

The group hardly issued statements mentioning Trump. None of its events at the RepublicanNational Convention in July were open to the press in contrast with the groups high profile in past years. Its get-out-the-vote drive largely barely mentioned Trump and focusedon vulnerableGOP senators in states with large Jewish communities. And even its inaugurationparty last month was closed to the media.

Now, the RJCis trying hard to get behindthe president. Trumps pivot from his neutrality on Israel in 2015 to an eager embrace earlier this month of Israeli Prime Minister Benjamin Netanyahu and his policies on the Palestinians and Iran have helped the RJC belatedly come around.

There was not a consensus [on the RJC board], said Elliott Broidy, a venture capitalist who was among about a dozen of the 50 or so board members who backed Trump prior to his nomination. Even when he was our presumptive nominee. Over time, people became more supportive. Now that hes president, theres deeper support on the board.

Fred Zeidman, another board member who is close to George W. Bush and could never quite bring himself to endorse Trump duringpresidential campaign, said it was incumbent on all Republicans to make sure government works now that the GOPis in control of all its levers.

I have a vested interest in making this White House a success, said the Houston-area businessman.

Asked by journalists Friday about Trumps most recent Jewish controversies including the White Houses omission of reference to the Jews in a statement on International Holocaust Remembrance Day, which was widely criticized by Jewish groups, including the RJC the groupsdirector Matt Brookstalked about Israel.

Theres a professional complaining class in the Jewish community that will criticize and attack Donald Trump no matter what he says, Brooks said.People who genuinely have an open mind, individuals and organizations, see he is following through on commitments he made on campaign, he is repositioning in a positive way the U.S.-Israel relationship.

Brooks alsopointed to the vice president. Hes a terrific partner to President Trump, you have a terrific team with the both of them.

In his speech, Pence too vouched for Trumps pro-Israel bone fides. If the world knows nothing else, it will know this: America stands with Israel, he said.

We told the ayatollahs of Iran they should check the calendar, theres a new president in the Oval Office. President Trump will never allow Iran to develop a nuclear weapon, this is my solemn promise to you.

He also described his recent visit to the Dachau concentration camp in Germany, where a Holocaust survivor gave him a tour. The crowd was clearly moved.

In one ballroom of the Venetian, Rep. Devin Nunes, R-Calif., the chairman of the House Intelligence Committee who has defended the Trump White House fromallegations it iscovering up Russian interference in the elections, pleaded with RJC members to have the presidents back, according to people who were present. Boris Epshteyn, a top White House aide who is emblematic of an emerging vocal minority among Republican Jews who have adoptedthe alt-rights confrontational style, made a similar pitch in another ballroom.

Sheldon Adelson, the casino magnate who owns the Venetian and who contributed tens of millions to the effort to elect Trump, had a private meeting with Pence prior to his speech. At Trumps inauguration, Adelson and his wife, Miriam, were accorded a rare honor to political donors, appearing on the capitols dais for the swearing-in.

Despite his access, Adelsons hoped-for administration officials have been waylaid: Former U.S. House of Representatives Speaker Newt Gingrich, former ambassador to the United Nations John Bolton, former New York Mayor Rudy Giuliani and Elliott Abrams, a mandarin in the Reagan and the George W. Bush administrations, are all on the outside looking in.

Seen as responsible for freezing them out is Chief White House Strategist Steve Bannon, a heroof the alt-right and the bane of neoconservatism, an interventionist outlook that many Republican Jews stillsupport.

But RJC members were able to hold uptheir Jewish representatives in government, however few. Rep. David Kustoff, the freshman from Tennessee, joked, in an easy drawl, that Jewish Republicans in the House grew by 100 percent, with himjoining Rep. Lee Zeldin, R-N.Y.

Eric Greitens, the steel-jawed Missouri governor, described how he rallied a diverse community this week to help clean up a vandalized St. Louis area Jewish graveyard, an effort joined at the last minute, by none other than the vice president. Pence called out inspiration over a bullhorn. Pence stood on the back of a pick-up truck. Pence wielded a rake.

Greitens, having depicted a sweaty, intense Pence, getting down and dirty for the Jews, finally got around toTrump.

The president had called me earlier that day, Greitens said. He said, Tell the people of Missouri that we stand with them in the fight against anti-Semitism.

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Republican Jews Celebrate Taking White House Still Wary Of Trump - Forward

Under the circumstances, its tempting to treat Trump as an anomaly and to view his mendacity as some sort of new development in conservative circles. But while Trumphas introduced a new level of dishonesty into the world of White House communications, the grim reality is that his duplicity builds on years decades, really of movement conservatism honing lies as a major and, in some cases, central public relations tactic.

For journalists like myself who have covered the reproductive-rights struggle for a long time, Trumps bottomless ability to lie feels very familiar.The anti-choice movement is the vanguard of the conservative movement generally. Tactics that anti-choicers develop and hone tend to spread out through conservatism, and nowhere is this more evident when it comes to the use of shameless lying as a tactic.

Whats remarkable about the anti-choice movement is that it lies about pretty much everything. Anti-choice activists have churned through a series of legal and rhetorical gambits over the years, and while the focus may change, one thing always stays the same: Their arguments are built on a foundation of lies. Every time, without fail.

The recent attacks on Planned Parenthood, for instance, have been justified by the claim that the venerated health organization sells baby parts.This is a lie. In therecent Supreme Court case, Whole Womens Health v. Hellerstedt, the state of Texas argued that a slate of abortion restrictions were necessary to protect womens health.That was a lie, which the court saw right through. In the Hobby Lobby v. Burwell case challenging the Affordable Care Acts contraception coverage requirement, the anti-choice side argued that certain forms of contraception work not by preventing but by terminating pregnancies.Thats a lie.

Anti-choicers are also fond of arguing that having an abortion often leads to deep regret and even mental health issues. This is a lie. Various states have sought to ban abortion at 20 weeks of gestation, claiming that fetuses can feel pain at that stage of development. This is a lie. Anti-choicers also argue that abortion causes breast cancer, infertility and other physical health problems. These are lies, which, unfortunately, have made their way into pamphlets that some states force doctors, in defiance of medical ethics, to give to patients.

Anti-choice activists are so shameless that they are now trying to pretend abortion reversal, a harmful and offensive fiction, is a thing.

This kind of relentless lying, unfortunately, can be highly effective. Its impossible to argue with someone who wont even concede basic facts, making any attempt at reasoned discourse fall apart.Reactionary arguments perform better when the plane of discourse is all feelings and stereotypes, and lying is the best way to make sure their supporters dont feel the tempting pull of reality-based thinking.

Thats why the popularity of outright lying as a tactic is spreading all over the right. It started spreading, unsurprisingly, in religious right circles. As with the anti-choice movement, the opposition to LGBTrights has been based on a series of lies, from the claim that same-sex marriage somehow threatens straight marriage to the current baseless hysteria about trans people using the bathroom. The creationist movement is not only based on lies, its about instilling lies in the classroom. We see the same story with abstinence-only sex education programs, which promoted false information about contraception in their material and justified themselves with the outrageous delusion that premarital abstinence from sexual intercourse was likely to be a viable option in 21st-century America.

But endlesslying really made its Great Leap Forward out of religious right circles into broader conservatism with the debate over climate change.

Denying that climate change is really happening and is caused by human activity is, objectively speaking, a mainstream conservative position. Fifty-nine percent of Republicans in the House of Representatives and 70 percent of Republicans in the Senate, as of March 2016, denied the scientific facts around climate change.

In other words, the majority of congressional Republicans are liars. Not liars in the way politicians are usually called liars. These arent people who shade the truth or exaggerate evidence or occasionally say untrue things they have to take back during a campaign. These are people who are committed to an outright lie about climate change, and who refuse to back down under pressure.

Thats why Trump isnt an anomaly. Instead, hesjust someone who correctly assessed that the Republican Party has no problem with lying as a strategy, and has taken that observation to its logical conclusion.

Thats why no one should be surprised to see Republican politicians falling in line with even some of Trumps most obnoxious lies. For instance, when the president started spouting off about how those who challenge him are just paid protesters, the GOP caucus started echoing this lie, marginalizing and undermining their own constituents with it.

Most of these politicians were perfectly happy to embrace lies about everything from abortion to climate change, even back when they thought Donald Trump was a dangerous rebel outsider who was out to destroy the Republican Party. So there was never any reason to think they would suddenly start feeling moved by the moral imperative towards honesty now that hes in the White House.

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Donald Trump tells a lot of lies but he's just building on a long Republican tradition - Salon