I didn't see any threads discussing the Senate health care bill so figured I'd start one. Here is what I see as being good and bad about the bill.
The Good
The Bad
So does this repeal and replace ObamaCare?
No.
ObamaCare is a system designed to give individuals access to subsidized health care coverage. It features a federal subsidy, based on income, for lower- and middle-income people to purchase health insurance. It requires health care insurers to sell to anyone regardless of pre-existing conditions. It requires all individuals to obtain health coverage or pay a penalty. It created government run health insurance exchanges where consumers could purchase individual market coverage.
Take out the one sentence that requires individuals to obtain health coverage or pay a penalty and the basic framework of ObamaCare is still intact in the GOP Senate bill.
Worse, the Senate voted to authorize cost sharing reduction payments (CSR's) to insurers through 2019 AND authorized retroactive back payments for any CSR payments they hadn't yet received. By authorizing these CSR payments the GOP is actually expanding ObamaCare. (CSR's are direct payments by the federal government to insurance companies to offset losses they may have by providing low-cost coverage to low income people under ObamaCare. CSR's were about $7 billion last year.)
It seems to me that the Senate plan (and the House) didn't repeal and replace ObamaCare, rather, they tweaked a few things here and there. There is no mechanism whatsoever in the Senate plan to address rising insurance premiums--they don't have the state opt-out waivers for pre-existing conditions that the House plan had, for example. And the payment of CSR's is just shifting taxpayer money to the insurance companies in a different way.
I don't know what was wrong with simply writing a one paragraph piece of legislation--"The Affordable Care Act is hereby repealed", reverting to the old free market system and starting over.
The Good
- Gets rid of the individual mandate
- Gets rid of a bunch of taxes
- Gets rid of funding for Planned Parenthood
- Basically is Medicaid reform, which is much needed since ObamaCare changed it.
- Keeps the pre-existing condition mandate--a voter favorite
- Subsidies are based on income levels, not age
The Bad
- Gets rid of the individual mandate--how to you keep insurance rates down without healthy people buying the insurance? Especially if you keep the pre-existing condition mandate?
- Gets rid of a bunch of taxes--how do you pay for the subsidies?
- Possibly leaves a back door for tax credits to be used to purchase abortions
- Medicaid reform has been kicked down the road up to 12 years from now. Lots of opportunities for Dems to reverse the policies.
- Keeps the pre-existing condition mandate--by far the biggest driver of rate increases
- Subsidies are quite generous. There is a sharp subsidy benefit cut-off for the middle class.
So does this repeal and replace ObamaCare?
No.
ObamaCare is a system designed to give individuals access to subsidized health care coverage. It features a federal subsidy, based on income, for lower- and middle-income people to purchase health insurance. It requires health care insurers to sell to anyone regardless of pre-existing conditions. It requires all individuals to obtain health coverage or pay a penalty. It created government run health insurance exchanges where consumers could purchase individual market coverage.
Take out the one sentence that requires individuals to obtain health coverage or pay a penalty and the basic framework of ObamaCare is still intact in the GOP Senate bill.
Worse, the Senate voted to authorize cost sharing reduction payments (CSR's) to insurers through 2019 AND authorized retroactive back payments for any CSR payments they hadn't yet received. By authorizing these CSR payments the GOP is actually expanding ObamaCare. (CSR's are direct payments by the federal government to insurance companies to offset losses they may have by providing low-cost coverage to low income people under ObamaCare. CSR's were about $7 billion last year.)
It seems to me that the Senate plan (and the House) didn't repeal and replace ObamaCare, rather, they tweaked a few things here and there. There is no mechanism whatsoever in the Senate plan to address rising insurance premiums--they don't have the state opt-out waivers for pre-existing conditions that the House plan had, for example. And the payment of CSR's is just shifting taxpayer money to the insurance companies in a different way.
I don't know what was wrong with simply writing a one paragraph piece of legislation--"The Affordable Care Act is hereby repealed", reverting to the old free market system and starting over.
