Posted by daniel
on Mar 7, 2017 in Politics
| 0 comments
So the details of the GOP ACA replacement are now public. Anyone care to guess what they are proposing? First – cut all the taxes on the rich that the ACA introduced. Second – cut the subsides for the poor to access health insurance. Third – remove the requirement that people have insurance (actually, it is more cynical than that; the requirement remains, but there will no longer be any penalties if you ignore it). Fourth – end the Federal government’s responsibility to help states pay for health care for the poor. That is the essence.
Some expanded analysis: Pretty much 100% of the tax cuts go to people earning over $200,000 per year. Reducing the subsidies will force a lot of people who currently have insurance to drop it, because they can’t afford it without the subsidy. And the lack of a penalty for being uninsured will cause a lot of young and healthy people to drop coverage. The cost of plans will inevitably spiral till they no longer exist. As the plans get more expensive, more people drop them, causing them to get more expensive, etc. And the Medicaid Expansion was the part of Obamacare where income redistribution from rich to poor (see the tax cuts above) was implemented at a national level. States that implemented expanded access to Medicaid had the federal government help out substantially with the costs. But it came with requirements as far as who was eligible and how much help they had to get. As of 2019 the requirements are gone. States will get a set amount of money (called “block grants”) that they can do whatever they want with. And block grants are a lot easier to cut in the future, because they are not tied in any obvious way to things with defined costs. By decoupling the spending from any specific outcomes, future Republicans can much more easily reduce the payments to states in order to pay for future large tax cuts for the rich.
And in case anyone is thinking that because they have employer-provided insurance this doesn’t affect you: Sorry, you are wrong. First, your employer will no longer be required to offer you insurance at all. Second, the plans you employer offers no longer have to cover everything they currently cover. Maternity care, for example, becomes optional. And new rules will prohibit covering abortions. Third, even if your employer wants to keep offering you the coverage you currently have, the chance that the current plans will remain available, much less at the current prices, goes way down in this new marketplace.
Last little piece: The bill also completely defunds Planned Parenthood by denying any and all money to any organization that provides abortions, regardless of what else they do, even if the other things they do would otherwise be eligible for federal funds.