You may not remember that Mike Jesus Johnson was a member of the Republican Study Group, the largest and most extreme Republican caucus. Back in 2019, Mike Johnson was the chairman. Here's their 2019 healthcare plan. (The full link is missing, but here's a summary.)
As someone who already knows far too much about insurance, I can tell you there's not much difference today. Republicans will propose what they always propose: Plans that will increase our costs, lower coverage, and increase insurance company profits.
First up, this old favorite:
The proposal ... explains how Obamacare has distorted the job market with the employer mandate and how Medicaid Expansion hurt the vulnerable by extending the program to abled-bodied individuals without dependents that compete with traditional Medicaid recipients, such as poor, pregnant women, looking for care.
We already know this is bullshit. Next?
"Promoting the use of innovative healthcare solutions such as telemedicine, direct primary care, association health plans, and health sharing ministries."
Association health plans are far too often scams, which is why most states (the blue ones, anyway) regulate them very tightly. And health sharing ministries are basically Ponzi schemes (see John Oliver above) where everyone's happy until someone gets really, really sick. (The ACA allowed them as an option to get the bill passed.)
So more bullshit, Christian style. What's next?
Restructuring ACA premium subsidies and Medicaid Expansion federal matching programs to fund state-administered grants to subsidize health insurance for low-income individuals, while protecting the medically vulnerable, such as low-income pregnant woman and children, that Medicaid was created to help;
Oh goody, more block grants! The thing Ronald Reagan invented in order to make it look like they gave a damn for the poor but cut services off as soon as the grants ran out. As opposed to Medicaid, which has to cover you if you're eligible, period. No limits. So that's a hard no.
Here's another red herring:
Not allowing insurance carriers to rescind, increase rates, or refuse to renew a person’s health insurance if they should develop an illness after enrollment;
Sounds good, right? Wrong. The recission problem that Obamacare fixed? People were being kicked off coverage AFTER they enrolled on the pretext that they did not declare every single goddamned preexisting condition. Like, people lost their coverage for not declaring they had things like teenage acne or a sprained ankle when they played high school sports. Just another excuse for cynical insurers to deny coverage.
But the one that has always been my personal favorite, because it sounds so reasonable while being so dangerous, is the old "selling insurance across state lines to increase competition and lower prices." I think this is what he's talking about here, but I'm not positive, since they've disappeared the full document. Still, I guarantee you Republicans will push for it, given the chance:
Unwinding ACA’s “centric approach” and returns most of the regulatory authority back to the states;
They want this so badly because it means scam insurance policies with threadbare coverage can be sold to desperate people all over the country. As we've seen, Republican state legislatures don't like to regulate (hello, Texas!), so they avoid it whenever possible. Which means people who buy one of these bare-bones policies will find that, when you need it, it won't cover much -- and there's no regulatory body that will make them comply with their promises.
All those outrages that Obamacare fixed? They will try to bring every single one of them back. That is, if Trump ever actually presents the alleged plan he's been talking about for eight years.
The Center on Budget and Policy Priorities has more here. Please note: "In particular, Project 2025’s health care agenda predominantly focuses on banning abortion and limiting access to contraception."
