House Republicans Unveil Plan to Dismantle Obamacare

Age-based premiums: now insurers can not charge more than 3 to 1 for the same plan between older and younger adults. Republicans have used “Obamacare” as a derogatory term.

During a debate over at AEI a few years ago, Chris Chocola, the then president of the Club for Growth, best described the Republicans’ handling of their House majority: “What good is a majority if you aren’t going to use it?”

The proposed plan, though, would be far less generous for people who have low incomes or who are older – and most policy experts believe that millions of people are likely to lose their coverage. The fallout could dog Republicans all the way into 2018 and 2020, when it could lead to a Democratic wave election like the one we saw in 2008. What they came up with instead was a dog’s breakfast that conservatives are, with some justice, calling Obamacare 2.0.

The GOP plan also retains numerous features the public likes in the Affordable Care Act, like protections for people with existing health conditions. And two out of three people who bought plans on the marketplaces set up by Obamacare receive the additional subsidies.

Ever since, whenever anything’s gone wrong in the health sector – whenever prices rose, or an insurance company dropped a line of business – Republicans have had an easy target: Obamacare.

You might, because you could receive less help from the government.

After swearing to the Almighty that Obamacare was so thoroughly putrid that it had to be repealed in its entirety, House Republicans have passed bills that retain the most popular features of the ACA, including allowing young adults to stay on their parents’ policies until age 26, banning lifetime coverage caps, and prohibiting insurance companies from denying coverage or charging more to people who have preexisting medical problems.

The House leadership bill isn’t even a repeal bill.

Hospitals and doctors have a vested interest in making sure as many Americans as possible have insurance so they can be paid for their services.

Subsidies are still there, in the form of tax credits, but they’re no longer linked to either income (as long as it’s below $75,000) or the cost of insurance. The House GOP draft eliminates the requirement that everyone buy health insurance or pay a tax penalty, aka the hated “mandate”.

Affluent young people might end up saving some money as a result of these changes. In an open letter to Congress, AARP laid out the math: A 55-year-old making $25,000 a year would pay $3,600 more a year for coverage; and a 64-year-old making $15,000 would end up paying $8,400 more a year for coverage, the senior citizens advocacy group said. This seems like a recipe for adverse selection death spirals. “History has shown when you freeze Medicaid, it dramatically affects how many people are covered”. The ObamaCare regulations it retains are already causing insurance markets to collapse.

Paul Ryan makes his case in a USA Today op-ed that this is the smartest approach.

The association voiced concern about the lack of Congressional Budget Office score that would estimate the bill’s impact on coverage levels. The exchanges for individuals who can’t get insurance through their jobs or aren’t poor enough for Medicaid have faced challenges, and insurers have threatened to leave exchanges many times in the past year because of all the uncertainty.

What if you choose not to have insurance?

The plan would also provide states with $100 billion to create programs for patient populations, possibly including high-risk pools to provide insurance to the sickest patients.

On Tuesday, Tom Price, the newly confirmed secretary of Health and Human Services, applauded the long-awaited House Republican replacement plan for the Affordable Care Act – despite the fact that the American Medical Association, the chief medical officer of Medicaid, the American Academy of Family Physicians, the American Nurses Association and many others have quickly and publicly opposed the legislation.