GOP HEALTH-CARE PLAN IS LARGELY DISASTER CARE

As expected, Republicans and Donald Trump’s braggadocio claims to repeal and replace the Affordable Care Act — aka Obamacare — with a better, more affordable health care plan was all talk and little planning.

On Monday, House Republicans unveiled their long-awaited, so-called plan, scrapping the mandate for most Americans to have health insurance in favor of a new system of tax credits intended to induce people to buy insurance on the open market.

There’s a big flaw there right up front. The working poor — the very folks the ACA was created for in the first place — usually don’t make enough money to actually pay for health care up front and wait to get the money back in tax refunds. Likewise, middle-income Americans won’t find the new plan particularly affordable if they’re forking over health-care money up front in hopes of getting a couple of thousand dollars back at tax time.

All this GOP bill does is provide a check mark for Republicans: Replacement for Obamacare so we can repeal it. And it’s a very poor excuse for a check mark, at that.

Meanwhile, it sets the stage for a certain and bitter debate over the possible dismantling of the most significant health care law in a half-century. In the ACA’s place would be a health-law far more oriented to the free market (which isn’t free and isn’t fair).

For starters, the bill would start the clock running on a 2020 phaseout of the expansion of Medicaid that has provided coverage to more than 10 million people in 31 states, reducing federal payments for many new beneficiaries.

It also would effectively scrap a requirement that people have insurance, and it would eliminate tax penalties for those who go without. But, people who let their insurance coverage lapse would face a significant penalty. Insurers could increase their premiums by 30 percent. In that sense, Republicans would replace a penalty for not having insurance with a new penalty for allowing insurance to lapse. In other words, the GOP has really only redefined “mandate.”

Worse still, the ACA requirement that larger employers offer coverage to their full-time employees would also be eliminated. Yes, you read that right: eliminated. Further, the plan would allow insurers to sell a leaner, less expensive package of benefits and allow people to use tax credits for policies covering only catastrophic costs.

The tax credits would start at $2,000 a year for a person under 30 and would rise to a maximum of $4,000 for a person 60 or older. A family could receive up to $14,000 in credits. But under the new version of the bill, the tax credits would also be reduced and eventually phased out.

That’s the fine print. But here’s the sales gimmick: The Republican plan would keep three popular provisions in the Affordable Care Act: the prohibition on denying coverage to people with pre-existing conditions, the ban on lifetime coverage caps and the rule allowing young people to remain on their parents’ health plans until age 26.

“Republicans will force tens of millions of families to pay more for less coverage — and push millions of Americans off of health coverage entirely,” said Rep. Nancy Pelosi of California, the Democratic leader.

And not only do we not know how they’ll pay for it. The GOP hasn’t even offered an estimated cost.

Two House committees — Ways and Means and Energy and Commerce — are expected to take up the legislation today. House Republicans hope the committees will OK the bill this week and clear the way for a full House vote before a spring break set to begin on April 7. The outlook in the Senate is less clear.

Democrats, of course, want to preserve the Affordable Care Act. A handful of Republican senators expressed serious concerns about the House plan as it was being developed. The committees plan to vote on the legislation without having estimates of its cost from the Congressional Budget Office and without a tally of how many people would gain or lose insurance. Accountability? What are you talking about? Naturally, the bill got the thumbs up from the Trump administration.

White House press secretary Sean Spicer used the only phrase that Trump can reliably repeat: “Obamacare had proven to be a disaster … .”

That assumes that one thinks extending health care access to at least 20 million more people in America was and is a disaster.

There is hope. On Monday, four Republican senators signed a letter saying a House draft that they had reviewed did not adequately protect people in states like theirs that have expanded Medicaid under the Affordable Care Act. And three others had already expressed reservations.

House Republicans say the bill would provide states with $100 billion over nine years, which states could use to help people pay for health care and insurance. But insurers and consumer advocates say the bill will create turmoil in insurance markets.

Talk about a “disaster.”