USA TODAY International Edition
Put the brakes on GOP health plan
The plan to replace Obamacare offered by House Republicans stretches to more than a hundred pages. It deals with an impossibly complex subject, with myriad unintended consequences. It has not been “scored” by the Congressional Budget Office ( CBO) for its price tag and impact on those who have insurance.
So what are Republicans planning to do? Rush it through.
Consideration of the measure began Wednesday in two House committees. If Republican leaders don’t pull the bill in the face of considerable internal opposition, the full House could vote on it within the next few weeks.
In contrast, Obamacare was the subject of lengthy public hearings and private negotiations during the winter, spring and summer of 2009. The first House committee action came that July, after the CBO came out with its estimates of the cost and the number of people who’d gain insurance.
The Senate Finance Committee did not approve Obamacare until that October. In the end, Obamacare passed on a party- line vote, but not until March of President Obama’s second year, after lengthy debate and analysis.
Republicans, on the other hand, have visions of getting a repeal- and- replace measure to President Trump’s desk by late April or May.
Good luck with that. Conservative House Republicans and interest groups already began balking as they read the plan’s details. They favor repealing Obamacare outright with little or nothing to replace it.
Centrist lawmakers, and some who represent rural or low- income districts, have different problems. They know that even a partial repeal could be devastating to their constituents who don’t get health coverage through work or Medicare.
Perhaps the worst part of the GOP replacement measure is what it would do to the individual market for health insurance.
If Republicans’ main complaint against Obamacare is that it has failed to keep premiums down on some state exchanges, they are doing their damnedest to make matters even worse.
Obamacare’s serious, but fixable, problem is that many young and healthy people are forgoing insurance. With an older, sicker pool of customers, insurers stop selling policies or raise their premiums, which prompts more people to drop out, creating a downward cycle.
By eliminating the individual mandate while requiring insurers to continue covering people with pre- existing medical conditions, the Republican plan further destabilizes these marketplaces.
The plan would relieve people of the penalty for skipping insurance ( currently set at $ 695 per year or 2.5% of income, whichever is higher). By rejiggering subsidies and tax credits, the proposal would also make it harder for low- and middle- income people to afford coverage. If these provisions went into effect, the precarious state exchanges would be all but certain to fail.
These consequences have not been adequately considered — and won’t be if Republicans keep trying to advance their measure before knowing how much it would cost and how many people it would cover.