Instead of deregulation of the health care/health insurance industry and free market reforms, ObamaCare-Lite brings us Democrat-Lite re-regulation and not even a whiff of anything resembling an open and free market.
Pres. Trump tweeted about the new bill: "Our wonderful new Healthcare Bill is now out for review and negotiation. ObamaCare is a complete and total disaster - is imploding fast!"
I sure hope it's open for negotiation. Otherwise ObamaCare-Lite will destroy the tenuous Trump coalition and usher in another leftist government in 2020.
Trump is already making excuses for his "wonderful" bill, tweeting 30 minutes ago: "Don't worry, getting rid of state lines, which will promote competition, will be in phase 2 & 3 of healthcare rollout. @foxandfriends."
And this 27 minutes ago: "I am working on a new system where there will be competition in the Drug Industry. Pricing for the American people will come way down!"
So after having 8 years to draft and polish up an ObamaCare repeal and replacement law and strategy, the Republican-Lite leadership only managed to produce "Phase 1" of their plan yesterday. Phases 2 and 3 are yet to come, along with lower healthcare costs, drug costs and re-engineered smoke and mirrors. This all sounds suspiciously like Nancy Pelosi's "we'll have to pass our healthcare law in order to know what's in it" bull shit.
I am not an "Always Trumper." I am aboard the Trump train reluctantly. Genuine repeal and replacement of ObamaCare is one of the few places I counted on the Trump train to stop. Now it seems that train is derailed before it even leaves the station.
After months of confusion and secrecy, House Republicans have finally revealed their Obamacare repeal legislation. While it's useful to have House Republicans on the record with a legislative plan, the plan doesn't offer any estimate for how much it would cost, or how many people it would (or wouldn't) cover. In general, it's not clear what problems this particular bill would actually solve.
The bill would replace Obamacare's subsidies with a system of tax credits and halt the law's Medicaid expansion at the end of the decade while grandfathering in many beneficiaries over the long term and giving states $100 billion in funding to work with to care for hard case patients. All in all, it's a fairly conventional Republican plan, modified in ways designed to mitigate recent political objections.
The tax credit is, for the moment, the most controversial component of the legislation. As in previous drafts of the bill, the credits are refundable, meaning that individuals will be eligible for them even if their total tax liability is lower than the amount of the credit. The federal government would pay people, even if their federal tax bill was zero. It's a subsidy, basically, rather like the one in Obamacare. Conservative legislators have argued that such a system would be little more than Obamacare lite. Sen. Rand Paul (R-Kentucky) has complained that any refundable credit is tantamount to "a new entitlement program."
Unlike Obamacare, which bases its credits on income, the GOP bills we've seen so far are based on age. That creates another set of political headaches, because it means that wealthier folks get tax credits, and because it means that older people would get less help than under Obamacare, in hopes of creating a scheme that lures more young and health people into the system.
The bill released tonight attempts to mitigate these problems by capping the refundable credit so that households earning more than $150,000 would be reduced, and individuals making more than $215,000 would get nothing at all. But that still leaves a credit that is refundable for most people, and adds a bit of additional administrative work: Under Obamacare, judging an individual's employment and income has proven more than a little difficult, and the same would continue to be true here.
So Republicans would be replacing one set of insurance subsidies with another set of insurance subsidies, while killing the individual mandate but leaving many of the law's insurance regulations intact (with a penalty for insurance gaps). There's a reason that legislators like Michigan Rep. Justin Amash are already referring to it as "Obamacare 2.0."
On the other hand, the bill would probably result in the disruption of current health insurance for millions (although it's hard to say with confidence how many, for reasons I'll explain in a moment), and we don't yet have an estimate as to what effect it would have on the budget.
Beyond that, the bill would provide a hefty payment to states, about $100 billion over 10 years, for states to use to fund safety nets of their own design. And then there's the bill's Medicaid rollback, another awkward balancing act. It keeps the state-level optionality granted by the Supreme Court in 2012, and allows states to keep the law's expanded funding for Medicaid beneficiaries up through the end of 2019, and for those who maintain continuous coverage after. So the enhanced Medicaid matching funds provided by Obamacare would dwindle away over time. This is as much a political compromise as an actual policy measure. Will it appease the four Republican Senators who pledged today to oppose the repeal of the law's Medicaid expansion? No one knows.
Grow a pair, Republicans. Have the guts to do what "we the people" sent you there to do. If you don't, well, enjoy your four years in power, Trump Ryan McConnell & Company, you'll never wield a gavel again in DC...ever.