Friday, January 31, 2014

Republicans Cancel Their Own Obamacare Alternative

The plan's authors -- in happier times, three days ago on Fox --
before they, and the world, discovered that they're idiots.

I'm not sure it's canceled so much as on-hold until they figure out how to un-screw it up:
The Congressional Budget Office recently analyzed a similar, though not identical, proposal and estimated that it would raise $613 billion in revenue over nine years, while six million people would lose their employer coverage in the five years after it took effect.
The initial reporting on the GOP's new proposal, by the Washington Post and National Journal as well as TPM, highlighted that the plan would likely lead to many Americans paying more for their insurance. National Journal observed that, under the GOP's plan as originally proposed, if you had an average health plan, you'd pay taxes on 35 percent of its costs.
It seems the Senate Republicans noticed this problem -- a significant tax increase on average Americans isn't likely to be a winner when the GOP has spent years decrying Obamacare's impact on the middle class -- and changed the proposal's specifics accordingly. Or they realized how poorly they worded the original proposal and sought to clarify their intentions. It's impossible to say, and their offices declined to explain.
It's hilarious that Republicans are trying their hardest to claim that Obamacare -- which was based on a conservative healthcare proposal developed by the Heritage Foundation as an alternative to "Hillarycare" -- would destroy the middle class, but they end up with an alternative plan that amounts to a hefty increase in healthcare costs and would throw millions of Americans off their newly found health insurance.

A key problem for the GOP is that, flawed though it is, Obamcare is working. That is, of course, why the party tried so hard to scuttle it, hoping to kill it before people realized it helped to have the government step in to control a confiscatory health-insurance market.

Soon, to the dismay of the GOP, people are going to start yelling, "Get your hands off my Obamacare!" They'll do that if they look too deeply at Republican alternatives. Apparently the Republican plan's crafters -- Senators Orrin Hatch of Utah, Tom Coburn of Oklahoma, and Richard Burr of North Carolina -- decided to read their plan and pulled it from the shelves.

That's some fancy legislatin' there, boys!

And if Forbes doesn't like it, how's it going to play in the Heartland, fellas?
As expected, lots of coverage in many different directions for this new plan which was dubbed the Patient CARE Act (PCA). Some have already elected to rename it so as not to be confused with the official name for Obamacare – the Patient Protection and Affordable Care Act (PPACA). One quick summary from Ezekiel J. Emanuel (NYT paywall here) framed the key differences to Obamacare this way:
1) “Pre-existing conditions would be rolled back” [loosely based on any lapse in health coverage]
2) Shrink Medicaid expansion by giving states a fixed amount per enrollee
3) Add a new income tax on employees for at least 35% of their employer-sponsored health insurance
This last one is the real shock-and-awe bombshell – and one that Forbes colleague Matthew Herper captured succinctly with his headline: The Proposed Republican Replacement For ObamaCare Is A Big Tax Hike (here).
It’s still early in the trajectory for “PCA,” but one thing it does highlight is how we may have reached a kind of healthcare cost saturation. There are simply no legislative gimmicks, games or alternatives left to avoid the last and final wallet – all of us as consumers. For some die-hard GOP faithful, this alone is an historic event – a sizable and transparent tax on working Americans.
There were other ideas as well, but some were hard to see as remotely viable technically or remotely successful with crucial swing voters. Two of these were:
“However, under our plan, every American will be able to access a health plan, but no American is forced to have health insurance they do not want. So, if an individual did not like the initial default plan selected for them, they would be able to switch plans, or affirmatively opt-out of coverage altogether.”
Welcome back junk health plans. With no minimum or Essential Health Benefits, it’s back to the gamification of healthcare plans, options and costs. It simply defies any actuarial science or logic for individuals to be able to pick and choose a health plan “that best meets their individual health care needs.” Under what conditions and criteria – and when? Using my smartphone strapped to a gurney in the ambulance? 
The second was targeted directly at non-Americans.
  Individuals with annual income above 300 percent FPL would not be    eligible for a credit, and only American citizens would be eligible for a credit.”
That doesn’t mean that non-Americans can’t buy health coverage, but that they simply wouldn’t qualify for any subsidy if their income was below 300% of FPL.
At least none of those nasty illegal immigrants working on minimum wage will get subsidized healthcare. At least part of the law is "Real American" Republicanism. The rest of it? Who knows? It'll be gone and forgotten by next Monday.

But keep at it, boys. You're bound to happen on something that makes sense eventually. But do read it next time before you release it to the hounds. This plan's already been torn to shreds.

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