Posted on 02/24/2017 1:06:42 PM PST by SeekAndFind
Politico reports today that a leaked draft of the GOP’s Obamacare replacement plan shows the House is not fiddling around the edges but moving toward full repeal and replacement of the law.
The legislation would take down the foundation of Obamacare, including the unpopular individual mandate, subsidies based on people’s income, and all of the law’s taxes. It would significantly roll back Medicaid spending and give states money to create high-risk pools for some people with pre-existing conditions. Some elements would be effective right away; others not until 2020.
The replacement plan would have no individual mandate. Instead, there would be a penalty of 30% for those who fail to maintain coverage. So people who wait until they get sick to sign up, as has been happening under Obamacare, will pay more. In place of the subsidies, the new plan would offer people tax credits of $2,000, with people over 60 getting double that amount. As for Medicaid expansion, states would have the option to continue it but federal support would end by 2020.
All of this is still going to cost a lot of money. The plan to cover those costs boils down to something similar to the Cadillac tax:
According to the document, there’s only one single revenue generator to pay for the new tax credits and grants. Republicans are proposing to cap the tax exemption for employer sponsored insurance at the 90th percentile of current premiums. That means benefits beyond that level would be taxed.
And while health care economists on both sides of the aisle favor tax-limits along those lines, politically it’s a hard sell. Both businesses and unions fought the Obamacare counterpart, dubbed the Cadillac tax.
The devil is in the details with proposals like this. The insidious part of the Cadillac tax was that it was designed to gradually ratchet down and eliminate the tax exemption for all employer sponsored insurance. We’ll see whether the GOP proposal has a similar design.
But if the GOP does anything close to what is described above then former Speaker Boehner was wrong when he suggested yesterday that the GOP would only wind up fixing Obamacare rather than repealing and replacing it. Removing the mandate and the subsidies ends the structure of the exchanges. I suspected the GOP might do that and then leave Medicaid expansion in place, but it sounds like they are going to end federal support for that as well. So this is not shaping up to be a repeal in name only.
Politico notes that the document is still preliminary since the GOP is waiting on scoring from the Congressional Budget Office. Depending what that scoring looks like, the shape of the replacement bill could still change significantly.
But it will keep the cronies happy. Insurance available for purchase across state lines. Insurance coverage that is selected based on what the purchaser needs not on what certain groups demand. Those two things would help reduce costs.
I agree, they shouldn’t be conflated.
There’s two issues involved in the user pays theory, one’s the moral (not my brother’s keeper) concept, the other’s public health. Most of the plagues that historically wiped out civilizations every century or so were related to large numbers of the afflicted and contagious spreading the disease to the healthy population. The foundation of that was lack of treatment for the vectors. If the proper concept of taxes is that they should only be used to buy things that are beneficial to us that we can’t afford to buy on our own, I’d have to put knowing I’m unlikely to get TB from that guy next to me with the cough in the category of something I don’t mind paying a little bit for.
So I guess I’d say I’m a semi-libertarian on that issue.
That’s what I’d envision. There would be an option of a low-cost catastrophic insurance policy. My plan would seem cruel, but in the long run first-aid and natural healing alternatives would get pretty good. With the mess we have now, it’s discouraging the search for low-cost health care solutions. How does that lead to anything that’s sustainable?
Ah, yes, the ‘public health’. “I can’t define it, but I know it when I see it.”
I’ll stick w/ the moral side of that argument; the govt does sh!t on the latter.
For example: allowing the flood of illegals/’refugees’/etc. that have RE-INTRODUCED TB and a plethora of previously eradicated ills\diseases...for political gain.
A few years ago, not only did they NOT protect the Citizenry (IE: ‘public health’) by KEEPING people out, they flew the infected INTO our Country; not treating ‘em at the vector sector. The CDC couldn’t even stay out of the politics!
In each of these examples, not ONCE did I note the State give the ‘public health’ any more heed than Fedzilla.
How well does FEMA do during these ‘natural disasters’? Food/water/shelter mired in red-tape. Bureaucracy run amok, each little fiefdom fighting the own ‘game of thrones’...
If I thought, for one moment, govt would do the RIGHT thing (what it was ‘created’ to accomplish), you’d have a point and my support. The pandemic\epidemic comes, I have no doubt it will be by wilful negligence of our ‘protectors’; who will be the 1st ones to high-tail it to the nearest ‘safe zone’ w/ orders to shoot to kill any pleeb attempting sanctuary\support.
I don’t think your plan’s cruel at all. The more individual choice, the more freedom. The big problem with “one size fits all” government programs is that they tend to get so much crap attached to them that they end up being the wrong solution for just about everybody.
We better hope so. The Republicans own it.
“We better hope so. The Republicans own it.”
Yep, I agree. What the Republicans, apparently, do not understand that Obamacare is now TOTALLY UNAFFORDABLE to anyone short of the 1%, unless they’re getting subsidies. Even 2 years ago, that was not yet the case.
They really need to find out what’s going on, if they want to have a prayer of killing this without killing their own futures.
That’s why I’m saying their obligation would be to sign up for insurance coverage as soon as they need coverage, or they get a two-year waiting period.
That person who loses their job and has a pre-existing condition would have to sign up for the government policy to be immediately covered.>>> i like it. disincentive in the market to delay getting insurance. Or catastrophic which has been pushed out of actuarial price point.
Agreed - the government was so entwined in health care before ObamaCare that it would have taken several phases to get it out - now it's even more complex. Progress is progress....
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