Editorial Board Concludes Ryan’s “Better Way” Could Lead To “Much Higher Costs” For Many, Allow States “With The Skimpiest Regulations” To “Set The National Standard”
Blog ››› ››› ALEX MORASH
The Washington Post blasted Speaker of the House Paul Ryan’s (R-WI) outline for replacing Obamacare, which could cut health care for millions of Americans and might lead to more rapidly rising insurance costs for an inferior product.
Ryan released a health care reform plan on June 22 under the “Better Way” brand that he hopes will become a fixture for Republican policy making in the next Congress. The plan seeks to repeal the Affordable Care Act (ACA) -- commonly referred to as Obamacare -- and replace it with a series of tax credits for Americans to purchase private insurance. The Post picked apart Ryan’s health care agenda in a June 26 editorial, saying the plan would be “hard on the poor, old and sick” and adding that “those in late middle age could face much higher costs.” The editorial board also derided the plan, which offers no cost projections or estimates for the number of Americans who could lose their ACA-compliant insurance, for being yet another vague proposal from a Republican Party that “has no excuse for blank spaces” after so many years of fruitless opposition to the health care law.
The Post noted that “the rate of uninsured Americans has plummeted to a historic low” since Obamacare was enacted, and Ryan’s plan does not appear capable of maintaining the same low rate. Instead, the plan would create tax credits that increase as Americans age, but it would also let insurers “raise premiums with age much more than the ACA currently allows.” Since “the proposal gives no sense that the two will come close to matching up,” it is possible that the tax credits proposed in the Ryan plan could be much smaller than the actual cost of insurance, making the reform agenda costlier for millions of middle-aged Americans currently benefitting from Obamacare. From The Washington Post (emphasis added):
House Speaker Paul D. Ryan (R-Wis.) seemed to promise better when he announced that he would roll out an ambitious policy agenda this summer. Instead, last week he released an Obamacare alternative that is less detailed in a variety of crucial ways than previous conservative health reform proposals. The outlines that the speaker did provide suggest that it would be hard on the poor, old and sick.
Mr. Ryan’s plan would replace Obamacare with a tax credit available to people buying insurance plans in markets regulated by the states, not the federal government.
The proposal hints that the credit would be sufficient to cover the cost of plans that existed before the ACA. This is not reassuring: Pre-ACA, individual-market insurance plans were often thin, with limited benefits, extensive cost-sharing and other elements designed to deter anyone who might actually need care. Without strong coverage requirements, insurers would have limited incentive to offer plans that appealed to people who may be — or may become — sick. States would be hampered in responding to these issues: The proposal would allow insurers to sell plans across state lines, so the state with the skimpiest regulations would likely set the national standard.
People with money to put into health savings accounts (which the proposal would expand), could cover gaps in thin insurance coverage with tax-advantaged out-of-pocket spending — but this would not be a realistic option for low-income people. As for the old, the plan would scale up the tax credits with age, but it would also permit insurers to raise premiums with age much more than the ACA currently allows. The proposal gives no sense that the two will come close to matching up; as in other conservative plans, those in late middle age could face much higher costs. For the sick, meanwhile, Mr. Ryan’s plan would offer an ultimate backstop by funding high-risk insurance pools. But health-care experts caution that this approach would cost a massive amount of federal money — a fact that has caused Republican lawmakers to balk at policies like it when fleshed out.
This harsh treatment of Ryan’s health care reform agenda mirrors the tone of criticism he drew from various quarters for each of his recent attempts to rebrand misleading Republican economic talking points as a “Better Way” forward. Ryan’s “Better Way” anti-poverty reform agenda, which was based almost entirely on right-wing media myths rather than professional economic research, was slammed by critics as being “doomed to fail” and “based on faulty assumptions.” His health care reform agenda seems to be drawn from the same right-wing media perspective, which considers the full repeal of the ACA to be of paramount importance despite the law’s continued success and the failure of every right-wing prediction of its demise to come to fruition.