House GOP’s stingy version of Obamacare is not true reform

After years of promises and weeks of work, the overhaul of the Affordable Care Act released by House Republicans on Monday and praised by President Trump on Tuesday is a disappointment in large part because it was crafted with one overriding goal: to make small enough changes to the ACA that the Senate could pass the bill with a simple majority “budget reconciliation” maneuver instead of the 60 votes needed to survive a Democratic filibuster of a more substantial bill. The rushed result is a weaker, stingier version of Obamacare that could cost millions of people their health insurance.

If House Republicans want to propose genuine health reforms, they would create free-market competition in health insurance by allowing the same basic policies to be sold in all 50 states. They would make such policies more portable, allowing adults to take them from job to job and into retirement. They would change tax rules to make such individual policies more attractive and palatable.

If House Republicans want to cut health care costs and increase access, they would make it easier for small organizations and groups to band together in pools to gain breaks on premiums and broaden the care that nurse practitioners and other health professionals can provide. And they would put reasonable limits on medical malpractice lawsuits to end the costly practice of “defensive medicine” in which physicians order unnecessary treatments simply to strengthen their case if sued.

But instead, what Speaker Paul Ryan and Health and Human Services Secretary Tom Price tout is a proposal to broadly limit the subsidies Obamacare provides and link them to age instead of income. The plan would continue to let people in more than 30 states receive federally subsidized Medicaid health coverage until 2020, when federal assistance for the newly enrolled would drop and federal assistance for all enrolled would be capped.

The GOP plan would drop the mandate that employers with 50 or more workers must provide health insurance. It would also drop the individual insurance mandate, under which people without health insurance are supposed to be fined.

In its place, the plan pushes people toward buying health coverage by including a “continuous coverage incentive” under which individuals who let their coverage lapse or never bought any would be hit with a 30 percent premium surcharge when buying policies. This doesn’t seem likely to be a strong enough incentive to avoid the “death spiral” emerging in some state insurance markets in which people wait until they’re sick to buy insurance, forcing the costs of premiums higher and making people even less likely to buy coverage. So what’s the solution?

The answer is a 50-state insurance market, subsidies for uncovered lower-income families and an individual mandate strong enough to ensure nearly everyone has at least catastrophic coverage.

A work in progress? As is, this isn’t progress at all.

Twitter: @sdutIdeas

Facebook: UTOpinion