Saturday, July 2, 2016

No Republican Plan to Replace Obamacare ?

Forbes: The Impressive New Obamacare Replace Plan From Republicans Burr, Hatch, And Upton - Feb 5th 2015

RCP: House Republicans Unveil Obamacare Replacement - June 22nd 2016

Wash Post: Republicans have a plan to replace Obamacare - June 22nd 2016

  • A refundable tax credit for Americans who don’t have employer-provided insurance. This is somewhat similar to the Obamacare subsidies, but individuals would not be subject to income limits, would not be required to purchase insurance through an exchange and could purchase a wider variety of plans, including low-cost, low-benefit “mini-med” plans that have largely been phased out under Obamacare.  
  • Expanding the use of private health savings accounts, or HSAs. Many Obamacare alternatives look to expand the use of high-deductible health plans paired with tax-free health savings accounts. That model, the GOP plan says, “helps patients understand the true cost of care, allows them to decide how much to spend, and provides them with the freedom to seek treatment at a place of their choosing.” 
  • Allow insurance companies to charge young people less and older people more. Obamacare permits insurers to charge older subscribers no more than three times what they charge younger ones for the same plan in the same state. Republicans call that 3-to-1 ratio “unrealistic” and propose allowing a 5-to-1 ratio to better align premiums with costs.
  • Funnel the costliest patients to subsidized “high-risk pools.” Obamacare’s mandates are meant to drive broad participation in the insurance market, so the premiums paid by a broad number of relatively healthy subscribers essentially subsidize care for the sickest. Without the mandates, many healthy Americans won’t buy insurance, forcing insurance companies to either deny coverage to sick customers or hike premiums to unsustainable levels. The GOP plan would solve that problem by establishing state-based “high-risk pools” for the sickest and directing $25 billion in federal support to them over 10 years.
  • Restructuring Medicaid and Medicare. The plan includes Medicaid and Medicare reform proposals that have been circulating for years — most prominently, in the federal budgets Ryan proposed as House Budget Committee chairman. Medicaid funds would be handed to the states either as block grants or as per-capita allotments. Medicare, meanwhile, would move toward a “premium support” model where seniors would choose a private health plan, and Medicare would pay at least a portion of the premium. The plan does not describe cuts in coverage, but these proposals have been previously floated in the context of long-term federal spending reductions.

One of the biggest lies told by the Democrats in defense of the indefensible Affordable Health Care fiasco, otherwise known as Obamacare (or Obamacan't as it should be called), is that there is no plan to replace it. 

First, this is a ridiculous argument to even try to make. The Democrats effectively broke a healthy free market health care insurance industry by taking the control away from the experts who kept over ninety five percent of their clients happy, and handing it over to Washington bureaucrats who one might wonder how they even manage to dress themselves in the morning.  

But as a matter of partisan blindness, it's impossible for Democrats to actually allow themselves to grasp that the involvement of the Federal Government is the cause of the problem, not the potential cure. They continue to see any increase in Federal control (even that which screws things up) as progress. They fundamentally cannot accept the idea that the solution might be to bring us closer to the days when ninety five percent of the insured was happy, rather than double down on the government controlled market, where barely half are happy. 

In other words, the reason that this was a bad plan was not in the details, or the execution (although both were awful), the reason this was a bad plan was the overall concept of allowing Washington bureaucrats to control something as important as our health care insurance industry. There is quite literally "no such thing" as a good replacement plan that involves the concept of these same bureaucrats maintaining control. The problem is not with their job description, the problem is the job existing in the first place.

Once that reality has been established in your mind, you can then see that ideas like refundable tax credits to consumers, and more control to the industry experts, would provide solutions to the problems we can all acknowledge have been caused. Just because it does not embrace the nonsensical belief that every plan "must" include government control or it rolls back progress... doesn't mean you cannot call it a plan.  

So yes, Democrats, the GOP has a plan. It may not be the one you like. It may not be the one you want. But every bit of tangible empirical evidence suggests it's the one the country needs. 

19 comments:

Honest, decent, truthful Rev. said...

Well, thank you, Ch, for responding to my challenge to Rat not with obscenities or incivility, but with alleged Republican planS (note the plural), white papers, "lofty" concepts, etc.

However, when I took the first of the articles you listed above (Forbes... etc.) and read through it, it became clear toward the end that the Republicans have no plan THEY CAN AGREE ON. The writer of the piece indicated that he has his opinions, others have theirs.

As the author himself says, "Republicans have been justly criticized for not coalescing around a plan."
________________

And there is this:

"While this proposal [Burr-Hatch-Upton] was unveiled with great fanfare, it’s little more than a lethargic rehash of last year’s unworkable ideas. Just like last year, this ‘new’ proposal falls woefully short. It effectively raises taxes on the middle class, removes bedrock protections for consumers and chips away at key coverage benefits that Americans rely on. In short: nothing in this white paper achieves what millions of Americans have today thanks to the Affordable Care Act – quality, affordable, health care.

"Finally, it’s important to remember that WHAT REPUBLICANS HAVE OFFERED ARE CONCEPTS, NOT FORMAL LEGISLATION. If Republicans were as good at writing actual legislation as they are promoting lofty but empty rhetoric, we could have a serious debate. WE’RE STILL WAITING."
--Sen. Ron Wyden (D-Ore.)
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So, Ch and Rat, what is the alternative Republican PlAN (not plural)?

Honest, decent, truthful Rev. said...

And as for the WaPo article:

White House spokeswoman Katie Hill on Wednesday called the GOP health-care proposal “nothing more than vague and recycled ideas to take health insurance away from millions and increase costs for seniors and hardworking families.”

“We hope that congressional Republicans stop trying to destroy a law that’s helping so many people and instead accept the President’s offer to work together to strengthen the Affordable Care Act in a bipartisan way to further improve Americans’ health care and the economy,” she said.

Honest, decent, truthful Rev. said...

My friend Rastus tells me, "Ain' gwine be no repeal."

C.H. Truth said...

James... with all due respect, finding Democrats who criticize what the Republicans are offering isn't exactly debunking the concept that they have proposals that they are offering.

It's called red herring.... turning "Republicans have no plan" into "Democrats don't like the Republican's plan" and then offering the additional red herring of whether or not there are votes for repeal.

Secondly you are not going to find anything that "everyone" agrees on, in something as complicated as this. The fact that there isn't unanimous agreement is sort of a weak argument, given the fact that a majority of the country doesn't believe Obamacare is the answer.

Bottom line remains the same James.

Republicans have a plan and could pass a bill in the House. You just don't like what they are offering.

Honest, decent, truthful Rev. said...

In all respect, I don't see them coalescing behind a plan and trying to pass it. If they are doing that, could you please tell me what specific plan that is?

Not a white paper. Not lofty rhetoric. Not a series of ideas. A specific plan. A legislative plan.

Honest, decent, truthful Rev. said...

BTW, Ch, they're really going off the rails on Ch's blog. If you/he allow that kind of language, that kind of invective, it's the slippery slope that leads downward only.

C.H. Truth said...

James - the Wash Post article has a list of the proposals they are offering. Not sure what else you want. There is not a bill, nor will there be a bill offered prior to the 2016 Election.

Barack Obama campaigned on single payer and other ideas that were never written into the law that was passed. Does that mean that it would be fair to offer that he had no vision or no plan, simply because he did not offer a specific prewritten bill... or because the final bill was something not at all what he campaigned on?

Politicians campaign on broad brush strokes during election seasons. Many times the specifics of plans are not argued during the campaign. It appears that you are blatantly holding the GOP to a higher standard on this issue, than you would ever hold the Democratic Party or Hillary Clinton.

C.H. Truth said...

James - I am not editing the comments on the legacy group blog. I never did in the past, and I find no reason to do so now. I will edit the comments here to provide safe haven for actual debate.

Honest, decent, truthful Rev. said...

Good enough. Let them behave like children over there.
Roger has deleted some of the gratuitous, totally useless obscenities.

Honest, decent, truthful Rev. said...

5:28 So you are admitting that the GOP Senate and House have only been campaigning all this time, not seeking TO GOVERN? Could they not have put forward a BILL and passed it? If not, why not?

Honest, decent, truthful Rev. said...

But I suppose you'll be saying, Why should they send a bill to Obama just so he can veto it?

That's the point: If they had sent to him a bill so good he would have looked bad vetoing it, they could have both sought to govern and yet campaigned at the same time.

C.H. Truth said...

James... the reality is that you cannot simply create laws that compete with other laws. You have to be able to repeal the existing laws.

So you cannot replace Obamacare unless it is first repealed. How many times has the House passed a repeal of Obamacare?

You cannot declare that to be a "political" move and then demand that the fact they do have not officially proposed the "second step" of replacement as also "political".

Indy Voter said...

Not true. You can replace sections of statute without separate language repealing the original statute. That is quite common in reauthorization bills. "Section XXX of Title ZZ is replaced with the following:"

You can also add statute that supersedes other statute. This language often says "Notwithstanding the provisions of" or something very similar to that at its beginning. It would be next to impossible to use this method to effectively override Obamacare, but it could be used to add the Hatch et al tax rebate provision and create a new health care class of people who do not have health insurance per we.

As pointed out above, this proposal has never been inserted into legislation, meaning it has never been debated in committee or voted on. So far, the Republicans have voted dozens of times to repeal Obamacare but have never voted on a replacement.

opie' said...

Impressive plan with lots of unknown costs or benefits. Oh well, maybe they can try again. LOL

but it comes with uncertain costs and an unknown effect on the number of insured Americans. It is the most anticipated piece of the six-part policy agenda now being rolled out by House Speaker Paul D. Ryan (R-Wis.) as GOP lawmakers move to establish a platform apart from presumptive

C.H. Truth said...

Sure Indy, in those regards you are correct.

I believe in many ways it's what Obama was attempting to do with his executive orders on immigration. He was trying to supersede the laws in place with executive action, while arguing he was just choosing to enforce it differently. Which is ultimately was determined not to be within his authority (which is largely why they went after the concept of standing, more than defending the action).

But I would argue that with a law like the ACA - that established exchanges, regulations, and other controls from the Government... I don't see how you go about offering high-risk pools and refundable tax credits when they compete with (but don't realistically supersedes) the staples of what is brought by ACA.

I still stand by the concept that some parts of ACA would have to be repealed (regardless of the semantics of how you do it). As long as the Democrats have 41 seats in the Senate and/or the Presidency that's not going to happen, regardless of if it is straight repeal or repeal and replace.

Indy Voter said...

I disagree on two points. Congress could choose to add on the tax credit provision without addressing the other issues, even though it makes little sense to do so. It would be a way for Republicans to weaken or even gut the exchanges and subsidies in the existing legislation that allows Democrats to say there was no appeal. Such is how legislative compromises are made.

Also, if Republicans proposed something that really made health coverage better without resorting to the Repeal! demagoguery they should get significant Democratic support.

C.H. Truth said...

I disagree on two points. Congress could choose to add on the tax credit provision without addressing the other issues, even though it makes little sense to do so.

Well there you go, Indy. I stipulate that it's possible to do so, if they really wanted to write laws that make little sense.

Honest, decent, truthful Rev. said...

INDY WISELY SAID: ... if Republicans proposed something that really made health coverage better without resorting to the Repeal! demagoguery they should get significant Democratic support.
____________

Amen and amen and amen.

But demagoguery is par for the Republican course of action these days.

Honest, decent, truthful Rev. said...

Read this, Ch.
It seems Trump's and Ryan's and other Republicans' "plans" to reform/repeal/destroy healthcare and/or medicare have put Republicans in a "circular firing squad."

http://thehill.com/opinion/juan-williams/286425-juan-williams-the-gops-pointless-obamacare-war