Did GOP do it right or offer ‘ObamaCare Lite?’
While Speaker Paul Ryan (R-WI) and others say The American Health Care Act keeps the GOP’s promise to do away with the Affordable Care Act, it also provides a stable transition to a patient-centered system that involves lower costs, more choices, and greater control over your healthcare.
“One of the challenges for this bill is it’s stuck a little bit in the middle,” observes Oren Cass of The Manhattan Institute, “in between ObamaCare and true conservative healthcare reform.”
An expansion of Medicaid
One of the best parts of the bill, he says, is how it addresses Medicaid, moving it away from an “open-ended entitlement” that rewards states for spending money.
“And shifts it to what’s called a ‘per capita system’ that says the federal government is going to help you with a fixed amount of money for every person you have on Medicaid,” Cass explains.
Robert Romano of Americans for Limited Government calls the legislation a partial repeal that falls short in some areas, including Medicaid.
“It keeps Medicaid expansion in place,” he says. “It only phases it out in 2020 and even then states that have expanded Medicaid, the current beneficiaries will get to keep their federal matching funds, provided that the person doesn’t switch insurance.”
Romano predicts that will create a rush to enroll people into Medicaid, which encourages its expansion.
“Whereas the bill that repealed Obamacare last year,” he recalls, “did away with Medicaid expansion in all its forms.”
Two visions of ‘healthcare reform’
When conservatives talk about health care reform, Cass says they’re really focused most of the time on actually making the health care system better.
“Meaning,” he says, “let’s actually make sure that we have enough doctors and hospitals in place that they are working efficiently, that costs are as low as they can be.”
If we do that and give people the choice of insurance products, Cass thinks the system will work better and people will be able to able to get the care that they need.
“The ObamaCare approach is the other extreme,” he says, “which is to say, Let’s have the government regulate every aspect of this. Let’s have the government tell hospitals and doctors how to do their work, what things should cost.”
“What we have here,” he says, “is kind of a hybrid that’s trying to keep all the promises of ObamaCare, things like pre-existing conditions, for keeping people on your insurance for defining what insurance should look like, and when you do that it’s hard to get the market working well and get costs down.”
The plan from House Republicans does create a new catastrophic-only plan, but Romano says that too is going to be subsidized. He questions whether people of certain income levels would still be able to qualify.
That, says Romano, is overlooked in the new House plan because they don’t go after the insurance regulations.
“If you were to get around Senate rules and overcome them, you could get full repeal of ObamaCare and that would include getting rid of the insurance regulations, something that is not addressed here,” he complains.
‘ObamaCare Lite’ from GOP?
It is for these and other reasons that people and organizations are referring to The American Health Care Act as “Obamacare Lite.”
Devon Herrick of the National Center for Policy Analysis says it reminds him of the film “The Good, The Bad and The Ugly.”
“It is an improvement,” stresses Herrick. “There is no mandate so you don’t have to have coverage, but unfortunately there are some provisions that are a little bit worrisome that I believe would not really lower the price of insurance.”
For example, Herrick tells OneNewsNow the ban on any kind of rating for pre-existing conditions stays put.
“The proposal would allow insurers to charge up to 30 percent more for those that don’t maintain coverage and then get sick and suddenly want to join the risk pool,” he adds. “That’s a good idea, to have incentives, but I don’t think it just quite goes far enough.”
To put things another way, Herrick says the Act is more or less a repeal of the things Republicans think will cause less of a furor.
“The states that expanded Medicaid would still get the same deal, for the most part, whereas states that didn’t expand Medicaid would get a per capita block grant,” he continues. “So, yeah, it’s an improvement but it doesn’t go quite far enough.”
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