February 11, 2015


A Detailed Analysis of the Republican Alternative to Obamacare (ROBERT LASZEWSKI, 2/10/15, Health Care Policy and Marketplace Review)

My sense is that voters will end up liking parts of both Republican and Democratic ideas. They might ask a reasonable question: Why can't we take the best from both sides? 

If Democrats would just admit Obamacare needs some pretty big fixes, and Republicans would be willing to work on making those fixes by putting some of these good ideas on the table, the American people would be a lot better off.

In fact, I am hopeful that this is eventually what will happen once Obamacare's failings become even more clear (particularly the real premium costs) and both sides come to understand that neither will have a unilateral political upper hand.  [...]

Let's take an in-depth look at the Republican alternative, "The Patient Choice, Affordability, Responsibility, and Empowerment Act."  [...]

Just how far the Republican tax credits would go in being able to pay for mainstream plans with deductibles and co-pays low-income people could afford will be critical to how effective this proposal would be. 

For example, a family of four in the 18 to 34 age bracket making up to $30,313 a year (125% of the poverty level) would be offered an advanceable tax credit of $4,290 a year. As a reference, the current Obamacare Blue Cross Silver HMO in Alexandria, Virginia costs $11,149 for a family of four with the parents age 30. Even if Republicans were able to substantially reduce Obamacare's current health insurance costs, the premiums would still not be realistic for this family--nor would the usual deductibles these commercial plans offer.

As low-income families make these comparisons, Republicans will be challenged to convince people to make the leap toward believing their plans will be far cheaper, the subsidies adequate, and any co-pays and deductibles affordable.

Republicans have argued that their tax credit would enable consumers to buy at least a catastrophic (big deductible) health plan for the value of the tax credit. Maybe. But what value is a big deductible health insurance plan to people who don't have a lot of money?

And, therein lies the Republican challenge--convincing people that their complex health insurance reform ideas provide people with more health insurance security than the problematic and complex Obamacare plan does. Take it or leave it--ours or theirs.

Again, I think Republicans would have been far better off taking a big gulp and accepting Obamacare as the baseline in health insurance public policy and then use many of their ideas to tell the American people how they could make it work a lot better.

After all, isn't that what most people really want?

Posted by at February 11, 2015 5:58 PM

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