Four Very Similar Weak Ideas   3 comments

Let’s be clear. The Republican majority with the ability to pass a repeal and replacement of Obamacare just taken office a few weeks ago. So it seems odd that the Democrats are accusing them of failing to put forth a replacement plan for Obamacare. After all, these things are supposed to take time and it might be a good idea to think it out a little longer than the Democrats did.

Republicans in both the House and the Senate have unveiled a number of proposals to replace Obamacare in the years since Barack Obama signed the ACA into law. They never got out of committee, but most share some key provisions … offering tax credits to consumers, expanding the use of health savings accounts or reforming Medicaid.

They say the devil is in the details and the strengths and weaknesses of each proposal can be found there. There are at least four plans being crafted to replace the law. I plan to focus on the Cassidy-Collins bill later, but basically, it repeals only Obamacare’s mandates, maintains its subsidies and taxes and allows states that like Obamacare to keep Obamacare.


In addition to the Cassidy-Collins plan, there are proposals offered by Paul Ryan and the Republican conference; Rep. Tom Price, R-Ga., who is now President Trump’s Secretary of Health and Human Services; the Republican Study Committee; and Sen. Richard Burr of North Carolina, Sen. Orrin Hatch of Utah, and Rep. Fred Upton of Michigan.

Image result for image of obamacare replacements

Price’s Empowering Patients First Act offering age-adjusted, refundable tax credits and individuals can opt out of the government health care programs and receive the tax credit instead. It creates a one-time, refundable tax credit for HSA contributions and increases the amount of money individuals and families can contribute. It caps the tax exclusion at $20,000 for families, $8,000 for individuals. It requires insurers to provide coverage to those with pre-existing conditions if the patient has had coverage for at least 18 months. It also creates high-risk pools and allows consumers to purchase insurance plans across state lines.

House Speaker Paul Ryan and the House Republican Conference have proposed A Better Way for Health Care. It also offers age-adjusted, refundable tax credits and health savings accounts. It also expands access to HSAs for BIA benefit and Tricare recipients. It caps tax exclusions for employer-sponsored coverage. It requires insurers to provide coverage for pre-existing conditions for those maintain continuous coverage and it creates high-risk pools. It allows consumers to purchase plans across state lines and covers dependents on their parents’ plans until age 26. It also reforms Medicaid.

The Republican Study Committee also came out with the American Health Care Reform Act of 2017 which allows tax deductions for individuals and families, health savings accounts that include Indian Service or Tricare and allows HSAs to be used for long-term care, premiums for HSA-qualified plans and Cobra. Of course, it requires insurers to provide coverage to those with pre-existing conditions who maintain continuous coverage and it creates high-risk pools. It also allows consumers to purchase plans across state lines.

Senators Richard Burr and Orrin Hatch and Representative Fred Upton have comes out with the Patient CARE Act. It also provides age-adjusted and income-based tax credits and expands health savings accounts to BIA benefit holders, as well as allowing consumers to use HSAs to pay for COBRA and premiums for HSA-qualified plans. It caps the tax exclusion on employer-sponsored coverage at $30,000 per family. It coverages pre-existing conditions and creates high-risk pools. It allows consumers to purchase coverage across state lines and keep their kids on the family plan until age 26. And of course, it reforms Medicaid.

All four of these proposals are basically the same bill with somewhat different details, so I am not going to focus on them beyond this brief coverage (unless Rick comes up with something he wants to share). All of them share an element that could work. It’s similar to a suggestion Ben Carson made at the Prayer Breakfast that made him a conservative darling. In his suggestion, he recommended annual deposits by the government from birth to whenever that you can pass onto your kids. That is similar to something parents here in Alaska can do with a portion of the Permanent Fund  Dividend to fund an Education Fund for their children. I know young people who are attending college without debt now using these accounts.

But I have issues with them because they really don’t go far enough. More on that later.





3 responses to “Four Very Similar Weak Ideas

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  1. It should be noted that when Rick and I decided to do this series, the American Health Care Act had not yet been unveiled. Rick says it’s essentially the four weak plans rolled into one, although I think it’s the American Health Care Reform Act of 2017 and that it doesn’t repeal Obamacare. It just sort of tweaks it. It’s like the Titanic headed toward the ice berg and they move the rudder 2 degrees while not easing off the speed. Will it be a sideswipe instead of a direct hit? Maybe, but it will still slice open the ship of the economy and take us to the bottom of the ocean. What we need is a full stop and course correction. But that’s not what the AHCA is.


  2. Well it’s all very complex.


    • Well, they’re attempting to “tweak” a 1500-page law that has 200,000 pages of regulation attached AND is failing. Average increase in premiums since go-live in 2011 is 153%.

      And recognize that the news coverage saying 24 million will lose coverage is misleading. Approximately 22 million on those didn’t want coverage in the first place, so would make a choice not to have coverage if the individual mandate went away. That’s not a tragedy. That’s returning freedom to the people.

      I know that sounds strange to people in countries with universal coverage, but Americans don’t like being treated like sheep. We want to make our own decisions, especially about something as personal as medical care. So, if they do away with the individual mandate … which is the biggest driver of the rapidly increasing deductibles … it is expected that a lot of people will opt out … or seek a high-deductible policy paired with a health savings account. Of course, you have the media claiming that favors rich people. It favors the frugal and the independent.

      This current law that’s been offered is really not a good solution. Rand Paul has come out with a better one. Hopefully, it’ll all be worked out in the amendment process.

      Or they could just repeal Obamacare and have a better outcome.

      The lack of coverage pre-Obamacare was always a “problem” only in the minds of the Hillary Clinton elite squad.


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