Speaker Ryan, this is not what conservative reform looks likeBy PHILIP KLEIN (@PHILIPAKLEIN) • 3/9/17 10:44 PM
House Speaker Paul Ryan, R-Wis., is making an aggressive effort to convince conservatives that his current plan to overhaul the healthcare system is "what good conservative healthcare reform looks like."
But the reality does not match the rhetorical case Ryan is making.
"It repeals Obamacare's taxes; it repeals Obamacare's spending; it repeals Obamacare's mandates," Ryan told reporters this week. "It creates a vibrant market where insurance companies compete for your business. Where you have lower costs, more choices, and greater control over your healthcare. And it returns power—this is most important—this returns power from Washington back to doctors and patients, back to states. This is what good, conservative healthcare reform looks like."
Let's take these comments apart piece by piece.
To start, it is true that the House GOP proposal appeals most of Obamacare's taxes, leaving the "Cadillac Tax" on high value employer health plans technically in place, but delaying it so long into the future (until 2025!) so there's no reason it will ever actually get implemented.
Though a Congressional Budget Office score does not yet exist, it's safe to say that it reduces spending relative to Obamacare, but it does not, by any stretch of the imagination, repeal all of Obamacare's spending. The bill would keep Obamacare largely intact between now and 2020, and presumes that Republicans would have the political will to let spending cuts go into effect during a presidential election year.
Assuming they do, after 2020, it still makes allowances for enhanced Obamacare-level spending to cover individuals who signed up for expanded Medicaid by that time. And it replaces Obamacare's subsidies to purchase insurance with a new federal subsidy scheme.
In addition, the bill introduces new spending that wasn't even in Obamacare. For instance, it proposes $10 billion in "safety net funding" for states that did not expand Medicaid and $100 billion in spending aimed at stabilizing insurance markets. It used to be that Republicans believed that market forces were the best way to stabilize markets, not a massive injection of federal funds.
And though it repeals the penalties attached to Obamacare's individual and employer mandates it retains other mandates that have driven up the cost of health insurance: such as the requirement that insurers cover individuals with pre-existing conditions and mandates on what types of benefits insurers must offer.
http://www.washingtonexaminer.com/speaker-ryan-this-isnt-conservative-reform/article/2616998
