On Monday, House Republicans released their long-dreaded proposed healthcare plan, the product of much infighting over the last several weeks (and years). Predictably, it sucks. Let’s a take a look.
Most significantly, the bill — dubbed the American Health Care Act — aims to eventually eliminate federal aid that offered Medicaid coverage to 10 million people in 31 states. Earlier versions of the legislation sought to curb the expansion immediately; this draft will implement a freeze by 2020. This is good news, because a lot can happen in four years. In 2013, Trump wrote an entire op-ed outlining the goal of “leaving borders behind,” insisting that in the quest for a global economy, “there won’t be any winners and losers as this is not a competition.” Codifying a four year delay into the text itself the best news I’ve heard since Trump announced he’d be running for president.
More immediately, though, the AHCA seeks to trash the mandate that requires large employers to offer coverage to full-time employees, as well as the penalties for those who opt out of insurance altogether. Anyone who allows their insurance to lapse, however, would face penalties of up to 30 percent, which will certainly have a chilling effect on enrollment for the healthy. Taxes on the wealthy would be slashed, naturally.
Republicans have said they intend to keep three provisions of the Affordable Care Act: Insurers will still not be allowed to deny coverage to those with preexisting conditions. People will be allowed to remain on their parents’ plans until they’re 26, and a ban on lifetime limits will remain in place.
These concessions have led to unrest within the party’s ranks, with some deriding the plan as “Obamacare Lite,” or Obamacare 2.0. As senators Rand Paul and Mark Meadows wrote in a typo-studded post on Fox News, “Conservatives don’t want new taxes, new entitlements and an “ObamaCare Lite” bill. If leadership insists on replacing ObamaCare with ObamaCare-lite, no repeal will pass.” Sad!
Like Obamacare, the AHCA would allow Americans to use tax credits to buy their plans. But as Vox points out, Obamacare is based solely on income, whereas the AHCA is based on a combination of income and age. Anyone earning under $75,000 will receive the same amount of assistance, and those above that threshold will have their credits phased out in 10 percent increments. The plan proposes tax credits as such:
This fixed amount would, according to CNN Money, shift federal responsibility to the states, which are less equipped to compensate for the difference. The effect would be either reduced eligibility, curtailed benefits or cuts to provider payments. The fixed credits also amount to significantly less help per person than Americans currently receive under Obamacare.
Of the many losers the AHCA’s unlikely passage would yield, older Americans would seemingly be the hardest hit, with insurers allowed to charge the elderly up to five times what they charge younger people. According to a study conducted on behalf of AARP, adults ages 60 to 64 would see a 22 percent increase in their annual premiums. Those in their 50s would face a 13 percent increase.
“You’re both jacking up the prices and giving people less of a subsidy, which is a damaging combination,” David Certner, legislative policy director for the AARP, told Vox.
In short, the AHCA would leave many American uninsured and, at the end of the day, dead, regardless of whether poor people forgo “the new iPhone that they love” to finance their plan.
But there’s a thick silver lining to be found here, and it comes from former House Speaker John Boehner, who from his comfortable perch out of public office now has the privilege of doling out this refreshing truth: There is no way the shambolic Republican party will ever pull their shit together to agree on a plan. Never.
“In the 25 years that I served in the United States Congress, Republicans never, ever one time agreed on what a health care proposal should look like. Not once,” he said in an interview at the end of February.
“If you pass repeal without replace, first, anything that happens is your fault. You broke it.”
“And secondly…if you pass repeal without replace, you’ll never pass replace, because they will never, ever agree on what the bill should be.”
In order to pass, the new legislation has to win approval in both the House and the Senate before heading to Trump’s desk. Good luck to it.
This article from the Village Voice Archive was posted on March 7, 2017