A Few Notes on the GOP Obamacare Replacement

  • The GOP Obamacare replacement plan was released yesterday, and it’s…not as bad as everyone on my Twitter timeline would have you believe (where, just like every other thing anyone not a Democrat does, it has been met with immediate outrage and stupid memes). Here’s a good review of a number of the key provisions.
  • The two most controversial pieces from the Democratic and Republican points of view respectively, are a repeal of the Medicare expansion (in 2019) that was actually supported by a fair number of Republican governors and provides coverage to a few million Americans, and a healthcare tax credit that is fully refundable, even if an individuals total tax liability is lower than the credit amount, meaning that the government would effectively be paying some people to have health care (and this tax credit would be available to all Americans who make less than $150,000, and most who make less than $225,000 annually. It is also based on how old you are). I don’t really have an issue with the tax credits portion of the plan, and I would like to see the Medicare expansion kept in place.
  • So there is some cause for liberal consternation, and there are a number of arch conservatives who are unhappy, which means this is the best kind of legislation Washington has to offer: a plan in which no one is wholly satisfied (my personal biggest objection to this plan is that it allows insurers to charge older folks up to five times as much as young ones, which seems backwards to me).
  • One thing that’s worth noting is that there has not been a CBO score attached to the bill, so we don’t actually know if this will be cheaper than Obamacare, in the end. And our representatives in Congress won’t know, since they’re planning to start markups on Wednesday. This means that the bill will be put together in the dark, quickly, and everyone will figure out what the fallout will be later. This is, for those keeping score at home, exactly what the Republicans (rightfully) castigated the Democrats for when the ACA was first passed. What’s old, it seems, is new again.
  • Another thing worth noting: Paul Ryan’s pet issue on healthcare (basically taxing employer provided healthcare to reduce market distortion) is not in this bill, which is frustrating as that is something I would have liked to actually see. (Here’s a good explainer of everything else in the law, courtesy of Vox)
  • As An Aside: There is also a provision of the GOPCare bill that liberals in my Twitter timeline have been keying off on that would effectively prevent lottery winners from being on Medicaid. Everyone is laughing and saying “haha isn’t the Republican party stupid,” but, frankly, I have zero problem with this. It is among the least unreasonable things in the bill. If you’re going to play the lottery, and piss away money (because you have to piss away money to even have a chance of winning the lottery, which is unlikely to begin with), then you shouldn’t be eligible for government healthcare benefits. And if you do win the lottery, buy your own damn health coverage. Effectively, this just creates a very powerful disincentive to playing the lottery, which is the among most morally bankrupt corrupt bargains our government has ever been party to (for those who don’t know, lottery ticket sales help fund education in many states). The lottery is regressive, and numerous studies have shown that people with lower incomes tend to both play the lottery more and spend a larger portion of their income on the lottery than those with higher incomes, and it’s their schools that then do not receive high funding (because the way we fund schools is messed up, too). If you want to spend what little discretionary income you have by flushing it down a toilet, fine, but don’t ask me to foot the bill for your medical expenses then (and this is a wholly different thing than the whole “food stamps shouldn’t be used for steaks” argument, so don’t @ me). 

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