The Department of Health and Human Services has drafted rules that would, starting in 2019, allow states to change the benefits health plans must provide and limit enrollment help for consumers.

The Washington Post reports that Republicans are still working to weaken federal powers under the 2010 health-care law and eliminate numerous provisions that have allowed millions to buy health insurance under the Affordable Care Act. After Republicans failed to pass any of their repeal-and-replace proposals this year in Congress, they are instead taking aim at rule changes that, although they don't go as far as changes in the law itself, will still take a toll on the program.

While the draft rule would still require ACA plans to cover 10 categories of medical services, the report says, for the first time, any state could choose to use benefits standards that are already in use by another state, or even to rewrite its own. This could reduce the number of visits that are covered for some kinds of care or cut hospital stays, according to health policy experts.