"This is a Republican welfare entitlement"
House Republican leaders sent a signal loud and clear: liberalism has already won.
Barring radical changes, Republicans will not be passing a bill that ushers in a new era of market-based healthcare. In reality, the GOP will either be passing legislation that rests on the same philosophical premise as Obamacare, or will pass nothing at all, and thus keep Obamacare itself in place.
This is genuinely distrubing, particularly coming from a party leadership that preached the evils of Obamacare, and their eagerness to repeal it -- if only voters would put them in the majority.
Now that they have a majority and a Republican president, their health care scheme, as it currently stands, would leave the Obama edifice largely intact:
Supporters of the bill could argue that it does make changes to Obamacare – repealing taxes, reducing spending and scaling back some mandates and regulations. There are even a few areas in which one could argue the bill moves health policy in a more conservative direction relative to the pre-Obamacare status quo. It provides for expanded health savings accounts and, though it would spend more money than otherwise would have been the case before Obamacare, it would overhaul Medicaid into a program in which states are given a per capita grant and provided the flexibility to run their own programs.
But at the same time, the GOP bill preserves much of the regulatory structure of Obamacare; leaves the bias in favor of employer healthcare largely intact, replaces Obamacare's subsidies with a different subsidy scheme, and still supports higher spending for Medicaid relative to what was the case before Obamacare.
Ultimately, it doesn't do much to foster the development of a free market system. Under GOPcare, individuals would not be able to take insurance with them from job to job, because tax credits would not be available to people who have an offer of job-based insurance. They would not be able to purchase whatever plan they want, because the federal government will still be dictating what has to be in insurance policies, making insurance more expensive then it needs to be. If this bill passes, everybody would have to get their insurance either through government, their employer via tax subsidy, or be left to purchase government-designed health policies using federal subsidies.
"GOPcare" has an ugly, statist ring to it. And some conservative House members have come out and said this bill is a disaster:
Some House Freedom Caucus members dismissed the bill as creating a new “entitlement program” by offering health care tax credits to low-income Americans. A Republican Study Committee memo sent to chiefs of staff, obtained by POLITICO, echoed those comments and blasted the bill’s continuation of the Medicaid expansion for three years.
“This is Obamacare by a different form,” former Freedom Caucus chairman Jim Jordan (R-Ohio) told POLITICO. “They’re still keeping the taxes in place and Medicaid expansion, and they’re starting a new entitlement.”
Freedom Caucus member Dave Brat (R-Va.) piled on, telling POLITICO he’d vote against it in its current form because “the bill maintains many of the federal features including a new entitlement program as well as most of the insurance regulations.”
"Now [they] are saying we're going to do repeal and replace but the bill does nothing of the sort,” he said. “[Speaker] Paul Ryan has always said the entire rationale for this bill is to bend the cost curve down, and so far I have seen no evidence that this bill will bring the cost curve down.”
The Republican Study Committee called the tax credits in Ryan's proposal "a Republican welfare entitlement," which is damning.
There will be a great deal of wrangling over this proposal, and others are sure to come to the surface in the days ahead.
But as an opening bid? Ryan an his cronies have offered Obamacare-lite. And that is unacceptable.