After six years, House Republicans released a health care plan. Sort of…. (More)

“Laying out the benefits without the more controversial costs”

That is to say, Speaker Paul Ryan and his GOP colleagues released a list of talking points:

House Republican leaders on Thursday presented their rank-and-file members with the outlines of their plan to replace the Affordable Care Act, leaning heavily on tax credits to finance individual insurance purchases and sharply reducing federal payments to the 31 states that have expanded Medicaid eligibility.

Speaker Paul D. Ryan and two House committee chairmen stood with the new secretary of health and human services, former Representative Tom Price of Georgia, preparing Republican lawmakers for a weeklong Presidents’ Day recess that promises to be dominated by angry or anxious questions about the fate of the health law.

But the talking points they provided did not say how the legislation would be paid for, essentially laying out the benefits without the more controversial costs.

It also included no estimates of the number of people who would gain or lose insurance under the plan, nor did it include comparisons with the Affordable Care Act, which has extended coverage to some 20 million people.

It has the usual right-wing goodies: cutting Medicaid, selling insurance across state lines, more reliance on catastrophic coverage and health savings accounts. Or as Speaker Ryan put it:

By contrast, Mr. Ryan said, with the Republican version of tax credits, people can “buy the health insurance plan of their choosing,” which could cost less and have less generous coverage than the plans now available.

“You get the freedom to do what you want and buy what you need,” Mr. Ryan said.

If only you could predict what injuries and illnesses you’ll get. And that’s the problem with “buy what you need.” When it comes to health care, you rarely know what you need until you’re hurt or sick … and then it’s too late to buy insurance to cover the care you need.

“The biggest financial benefits would go to older Americans, like, say, Secretary of State Rex Tillerson”

The New York TimesMargot Sanger-Katz explains how the GOP plan is welfare for the wealthy:

The plan would make major changes in how health care is financed for Americans who don’t get coverage from work. It would greatly expand the number of Americans who could benefit from federal help in buying health insurance, but it would change who benefits most from that support.

Obamacare, as the A.C.A. is known, extended health coverage to 20 million Americans through two main mechanisms. It expanded Medicaid coverage to Americans below or just above the poverty line in states that participated, and it offered income-based tax credits for middle-income people to buy their own insurance. Obamacare was a redistributive law, transferring money from rich to poor.

The Republican plan would alter both of those programs, changing the winners and losers. It would substantially cut funding for states in providing free insurance to low-income adults through Medicaid. And it would change how tax credits are distributed by giving all Americans not covered through work a flat credit by age, regardless of income.

That means that the biggest financial benefits would go to older Americans, like, say, Secretary of State Rex Tillerson. If he didn’t have a job in the Trump cabinet and access to government coverage, a 64-year-old multimillionaire like him would get the same amount of financial assistance as someone his age, living in poverty, and he would get substantially more money than a poor, young person.
The plan includes additional features that redistribute resources from the poor to the rich. It would allow Americans to sock more money away for health spending in special tax-free health savings accounts. The benefits of such accounts fall largely to higher income-people who pay more in taxes, and a recent analysis of current health savings accounts found that they are held disproportionately by families with high earnings.

So if you’re rich enough to already afford health insurance and a health savings account, this plan will ease your pain. If you’re not, well … dammit, get rich!

This detail-free hooey will doubtless be discussed as a “serious” plan to “improve” the ACA. But really it’s just another GOP plan to take money and benefits away from working families … and give it to the rich.


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