House Republicans have finally produced the long-awaited ObamaCare replacement bill.
Chris Jacobs of the Texas Public Policy Foundation took a look at the plan and was distinctly unimpressed:
The bill falls far short of making good on the promise to fully repeal Obamacare and fails to fundamentally change federal control over supply and demand of healthcare.
This plan fails to repeal most of the costly mandates and insurance regulations driving up premiums and deductibles.
This plan replaces Obamacare’s subsidy scheme with a new costly federal entitlement in the form of a refundable tax credit.
This plan leaves significant portions of the flawed and costly Medicaid expansion intact by delaying the freeze on Medicaid enrollment, maintaining the expansion of the program to the able bodied, and providing a pathway for non-expansion states to accept enhanced federal dollars.
Congress should be focused on policy solutions that respect states, patients, doctors, and families by lowering costs, increasing quality of care, and providing greater choice and competition in healthcare while empowering states. This plan does not live up to those benchmarks and continues many of the flawed solutions first promulgated under Obamacare.
This doesn’t sound good:
Some conservatives may note the significant changes in the program when compared to the leaked discussion draft — let alone the program’s initial variation, proposed by House Republicans in their alternative to Obamacare in 2009. These changes have turned the program’s focus increasingly towards “stabilizing markets,” and subsidizing health insurers to incentivize continued participation in insurance markets. Some conservatives therefore may be concerned that this program amounts to a $100 billion bailout fund for insurers — one that could infringe upon state sovereignty.
This sounds pretty heinous as well:
Continuous Coverage: Requires insurers, beginning after the 2018 open enrollment period (i.e., open enrollment for 2019, or special enrollment periods during the 2018 plan year), to increase premiums for individuals without continuous health insurance coverage. The premium could increase by 30 percent for individuals who have a coverage gap of more than 63 days during the previous 12 months. Insurers could maintain the 30 percent premium increase for a 12 month period. Requires individuals to show proof of continuous coverage, and requires insurers to provide said proof in the form of certificates. Some conservatives may be concerned that this provision maintains the federal intrusion over insurance markets exacerbated by Obamacare, rather than devolving insurance regulation back to the states.
There are good things in the bill: It zeroes out penalties from the insurance mandate, repeals a host of ObamaCare taxes, and defunds Planned Parenthood. But it leaves in place the structure of federal interference in health insurance. That’s a huge disappointment, considering that pretty much every House Republican ran for election on a platform of full repeal of ObamaCare.
They can do better.
(Note: I’m also not seeing language that makes good on President Trump’s joint address promise to allow health insurance sales across state lines. I’m waiting to hear back Jacobs to see if I missed that.)
Edited to add: Just after I published this I got a reply: