Well, we finally have a Republican alternative to the ACA. They have realized that critiquing the law is not enough, there has to be some kind of alternative.
And so, some Republican Senators have brought forth the idea of what a Republican health care system would look like.
Here are the pertinent differences:
1) Eliminates the requirement that all citizens have health insurance. And eliminates the basic requirements that the ACA required of any policy. So, that part is back to where we were before.
2) Eliminates all the additional taxes and fees involved in the law which means that the subsequent tax subsidies that help pay for insurance are gone.
3) No requirement to cover people with pre-existing conditions…although people who have had at least 18 months of continuous coverage are eligible for future coverage.
4) While the proposal states that it keeps the ACA “no limits” on lifetime coverage, there is a loophole that allows insurers to begin to impose those limits again.
5) There will be some tax credits for the poor to help pay for coverage. These credits can be adjusted for age (as they are now), but NOT on geography. Which means that geographic areas with higher premiums will NOT get higher tax credits. The credits will be uniform.
6) These tax credits would be available to lower incomes that are 3 times the poverty rate. (The ACA allows credits up to 4 times the poverty rate).
7) Older people would pay more under the GOP plan. Currently, the ACA limits premiums for older people to be limited to a maximum of 3 times what a younger person would pay. The GOP plan raises that ratio to 5 times the rate.
8) Although Medicare coverage would not be changed, the GOP plan revamps the Medicaid program. Limits on funding. Limits on populations. And eliminates the “expanded” Medicaid, which is currently an option for the states.
9) The GOP plan says they are leaving employer based programs alone. However, the limited tax credits, still available, are financed (remember taxes and fees have been eliminated) by taxing 35 per cent of the employer benefit….treating it as additional income to the employee.
There, finally, is the GOP idea of health care. It benefits employers. It will not substantially reduce the number of uninsured. It will continue the process of younger populations using the emergency room as their health plan. And it will keep the poor in poverty.
The comparison is stark — and I hope everyone examines this reality.
The ACA may have its technological problems — but the GOP has no intention of fixing the underlying health care policy problem.
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