Youve heard all about pre-existing conditions, and allowing young adults to stay on their parents health insurance policies. But if you want to understand what Republican plans to replace the Affordable Care Act would mean for the country, and perhaps for you individually, pay close attention to the money.

Thanks to the Affordable Care Act, the federal government now spends tens of billions of dollars each year providing financial assistance to people who buy insurance through HealthCare.gov or one of the exchanges (like Covered California) that some states run on their own. The financial assistance takes two forms tax credits that discount premiums, and direct subsidies that reduce out-of-pocket costs.

Most of the Republican schemes under consideration, including a working draft of House legislation that Politico obtained last week, envision the federal government continuing to provide assistance to people who buy coverage on their own. But the assistance would take a different form with a new formula for the tax credits, and no special assistance for out-of-pocket costs.

The result would be some fairly dramatic shifts in who gets insurance, how much they pay for it, and, eventually, what kind of insurance they have. This isnt accidental. The decision to restructure financial assistance for insurance flows directly from the very different way Republicans and Democrats think about health care.

Basically, Democrats believe there should be a right to decent, affordable insurance. They wrote the Affordable Care Act with that principle in mind. Democrats didnt achieve their goal millions of Americans remain uninsured, while millions more with coverage still face high costs. But something like 20 million people now have comprehensive policies they didnt have before. Overall, financial security and access to health care have improved.

Republicans take a different view. They are willing to give people a tax break to defray health insurance costs, and some Republicans are even willing to extend assistance to lower-income people who dont make enough money to owe income taxes. But Republicans reject the idea of government guaranteeing coverage, and their proposals to replace Obamacare wouldnt even attempt to provide such a guarantee.

Its a big reason why the mainstream Republican plans would likely result in more uninsured, weaker coverage, or some combination of the two.

How Obamacare Assistance Works

Under the Affordable Care Act, if you buy insurance through HealthCare.gov or one of the state-run exchanges, you can get tax credits that help offset the cost of premiums. These are special tax credits, in that they go straight to the insurance companies at the beginning of each month, so you dont have to wait until tax-filing season to get the money.

The tax credits are also refundable, which means that if your income tax liability is smaller than the value of the credit, or if you have no liability at all, you still get the full value. This is very important in health care because a large number of people buying through exchanges are working in low-paying jobs. They are hotel housekeepers and clerks at big-box stores, home health aides and security guards. If the credits werent refundable, they wouldnt get much or any assistance, even though they are the ones who need it most.