Speaker Paul Ryan has been out saying his version of healthcare is “what good conservative healthcare reform looks like”.
“It repeals Obamacare’s taxes; it repeals Obamacare’s spending; it repeals Obamacare’s mandates. It creates a vibrant market where insurance companies compete for your business. Where you have lower costs, more choices, and greater control over your healthcare. And it returns power—this is most important—this returns power from Washington back to doctors and patients, back to states”.
Yes and no, mostly no. It maintains the federalization of healthcare which is what most conservatives don’t want. Federalization is the problem as they see it.
It repeals Obamacare mandates, most of the taxes and some of the spending.
Philip Klein of the Washington Examiner explains how the Ryan claim is largely hyperbolic.
“If the federal government is dictating the design of insurance policies and imposing regulations that naturally drive up the price of insurance [as it will continue to do under Ryan’s plan], then the market won’t be vibrant, consumers won’t have more choices, and they won’t experience lower costs.”
The Obamacare regulations and mandates must go if Republicans hope to achieve a vibrant healthcare market that Ryan envisions.
“If Republicans were to have pushed a true free market plan, it would have removed the regulations and mandates on the type of insurance that must be sold and drastically reduced spending through Obamacare. By reforming the tax code, it could have used money from changing the bias in favor of employer-based coverage to help individuals purchase coverage in an open market.
To be sure, under this scenario, Republicans would still be fighting off attacks that their plan covers fewer individuals than Obamacare. But they’d also be able to credibly argue that their plan reduces premiums, increases choices, reduces spending, and cuts deficits. This would all fit into the narrative that they’ve been trying to push for months: Obamacare was an unsustainable promise, they inherited a mess, and they had to act responsibly to clean it up.”
Ryan’s plan, Klein says, will leave them vulnerable to attack for covering fewer individuals than Obamacare covers. The reason being the subsidies aren’t as generous.
There will be fewer people getting insurance thus hastening the crash of Obamacare Jr.. This is a form of Obamacare. It is a variation, not a replacement.
Calling this a conservative healthcare plan is disingenuous.
One of the more offensive aspects of the new bill is it punishes people who don’t pay for continuous insurance.
There is a 30 percent surcharge on premiums for people who have not been continuously insured. This will discourage some people who only want a cheap policy. It’s also not needed since Obamacare rules remain in place.
Republicans won’t simply repeal and replace, probably because they are fearful. They are installing their plan in three stages but the second and third stages will still be subject to the same filibuster they claim to be avoiding.
Republicans say the essential parts of Obamacare cannot be repealed through “reconciliation” – with a simple majority vote of 51 as opposed to 60 votes – because the parliamentarian said “no” as per the Byrd Rule.
Tht means regulations which raise prices and kill competition remain. They are the heart of Obamacare and they will stay. They are the very things that must go.
We are told Tom Price will eliminate much of Obamacare with rules and the second and third stages will take care of the rest. Will they do reconciliation then?
The parliamentarian who suddenly has all this power is nobody with no power. She can’t veto anything. Her rulings can be overturned with a simple majority.
Dismantling Obamacare with Obamacare Jr. leaves the core in tact.
Obamacare is a scheme. It is the scheme that needs to be obliterated. Anything else is a repair or a temporary fix that doesn’t deal with the overriding problems.
Charles Blahous of the Manhattan Institute writes that the projected savings estimates for a repeal of Obamacare are directly affected by whether the Obamacare insurance regulations are repealed.
They say they can’t use reconciliation but the Senate has already used reconciliation putting adherence to the Byrd Rule in the category of a convenient excuse.
The true repeal will come in later stages and the Democrats will block it. Republicans will blame Democrats but the media and the Democrats will blame Republicans.
It’s not all bad. The Medicaid reform in Obamacare Jr. will end the federal-state matching funds. States that want to give “freebies” to their residents might actually have to start telling the truth. There would still be a federal contribution but it would be capped based on population. It’s not great – it’s better – but it still allows for the next Democrat to come into the presidency and expand it with ease.
Obamacare Jr. includes the refundable tax credits.
If people want to cover pre-existing conditions, it has to be paid for and this is how they are choosing to do it. Tax credits will be awarded if the recipients buy healthcare or not. The problems with that are obvious.
The core of Obamacare is the federalization of healthcare – that’s what has to go – yet, that doesn’t go because Republicans seem to think the Bryd Rule and a parliamentarian with no veto power is the final word, not reconciliation. Let’s face it, they’re scared the free market won’t work and they will have a worse disaster on their hands.
All of the bills this replacement is based on required the repeal of the core of the Obamacare bill and that’s what makes this a poor substitute for the prior bills put forth.
The premiums must be brought down through competition, allowing insurance providers to sell catastrophic coverage plans and creating a plan or plans affordable for all.
To do that, the benefit and design mandates of Obamacare must be returned to the states. Current holders of insurance could be grandfathered in. Healthy people would be incentivized to buy health insurance if the didn’t have to pay for everyone else. There is also the hope that insurers would provide at least one plan equal to the tax credit.
Democrats want unaffordable great care for everyone and this would provide catastrophic care for everyone.
The current plan achieves some of this but it hardly seems the best they can do.