In their effort to overhaul the Affordable Care Act, the GOP plan released on Monday evening doesn’t go far enough for many conservatives and yet strips away many of the protections that the ACA was designed to provide.
For each problem the GOP plan tries to solve, it simply provides new issues, all while passing tax savings on to the rich. The proposed tax cuts total to $346 billion, but only income earners of $200,000 or more will see those.
Though some original pieces of the ACA remain: the so-called “Cadillac tax” that is levied against high-end employer funded plans, protections for preexisting conditions, dependent care until age 26, and many limits from the ACA do remain intact, to the chagrin of many more conservative lawmakers. Meanwhile, the cuts in the plan are too large to satisfy Democrats.
Republicans long decried the individual mandate on healthcare, which led to philosophical debates over fundamental rights to health. In response, the GOP plan cuts that completely out. However, they do add in a 30 percent penalty for those that allow coverage to lapse. This will simply discourage the uninsured from getting coverage, while still not accruing enough funds to pay for their tax credits.
Instead of straight subsidies, the plan is to shift toward age-based subsidies. The reasoning behind this is simple: as lower income citizens age, their healthcare costs increase. There are many studies that show an exponential increase in healthcare expenditure for those over 50. However, the GOP plan favors this over helping provide health care to the poorest citizens. While tax credits do remain for those in poverty, they aren’t enough. Meanwhile, those over 400% of the poverty line will still gain credits. This means that more people will gain coverage assistance, at the expense of those who NEED the assistance.
Because of the lower tax credits, health policy experts like Loren Adler see that between 15 and 20 million people will lose coverage. While Adler does see that deficits will likely go down, it will have to be because fewer people will be insured, lower income people will have to pay more, and Medicaid will eventually face massive cuts.
As far as Medicaid goes, it is safe, for the near future anyway – but only for the states that elected to expand the program under the Affordable Care Act. Those states will essentially get the same amount of funded as they do now, but without the option of more funding for higher numbers of recipients. The states that did NOT elect to expand Medicaid will get a flat rate to split for healthcare improvements. This protection is only in the short-term though – Medicaid expansion will begin phasing out by 2020.
Congressional conservatives wanted to see an end to Medicaid expansion, while Democrats and state governors, regardless of party affiliation, have fought fiercely to keep the funding. Under the GOP plan, no one gets what they want in the long run.
A full budget report isn’t currently available, so while cutting coverage and cutting taxes on the wealthy, we still don’t know how the GOP plans to pay for their overhaul. The plan seems to be a cobbled-together, over-bargained mess that was thrown together simply so the GOP could show efforts toward repealing the ACA, which is a platform that many of them were elected on. But this bill offers no real relief from the worst parts of the ACA while cutting the best parts.
Sure, the Affordable Care Act faced ballooning healthcare costs for the middle class and an increasing deficit with no foreseeable funding fix. However, this new plan will see ballooning healthcare costs for younger, lower income Americans with an increasing deficit and no plan to fix it. This bill simply is not a fix for anyone.