The Long-Awaited Obamacare Replacement

A plan that's kind of like Obamacare, except worse
U.S. Senate
Richard Burr

The Republicans have finally offered their alternative to Obamacare through three GOP senators, one of them North Carolina’s Richard Burr. We’ve been waiting for this for a long time.

You’ll be relieved to know it’s a lot like Obamacare but shittier.

The clearest analysis I found was Sam Baker’s at the National Journal:

In essence, the plan attempts to lower health care costs by making people shoulder a greater share of those costs—or “sensitizing” consumers to the actual cost of health care, as Senate aides put it in a meeting with reporters on Monday.

Most people don’t recognize how much their employer contributes to their health care plan and don’t see the costs the insurance company covers: If people are spending more of their own money, many conservatives argue, they’ll be smarter consumers. Overall costs will come down, the argument goes, if consumers have more “skin in the game” …

About 85 percent of Americans get health benefits through their job(s). Those health care benefits have two kinds of tax protections. First, the employer can deduct its costs. Second, the employees’ share of their premiums comes out of their paychecks before taxes are taken out. The GOP plan would cap that exclusion, so that only 65 percent of the average plan’s costs would be tax-exempt.

If your plan is in line with the average, you'd pay taxes on 35 percent of your premium. If it's above average, you'd pay taxes on more. If it's below average, you'd pay taxes on less. The idea is to make consumers more aware of how much their health care plan costs (by making them pay part of it), so that employees will go to their bosses and ask for cheaper plans.

So this is the solution: Control health care costs by making 85 percent of the nation pay more for employer-based coverage so they’ll feel more financial pain and beg their employers for cheaper insurance that covers less. Magnificent.

Oh, and what of this horrible individual mandate, this thumb up the Constitution’s keister, this unprecedented power grab by the power-hungry dictator Obama?

Problem solved. Just force people to keep whatever insurance they have under the threat that they’ll never be able to buy health insurance again (from Olga Khazan in The Atlantic):

[J]ust like under the ACA, the GOP plan would prevent insurers from excluding people based on pre-existing conditions or charging them more, but only if the applicant has been insured for “a period of at least 18 months.” So, sure, go without insurance. But when you’re ready to have a baby, or if you get cancer, insurance companies could deny you because you’ve been living coverage-free.

“You can't wait to sign up just because you're healthy, because you won't be able to buy insurance when you're sick,” [the Kaiser Family Foundation’s Larry] Levitt told me. “In some ways, I think it's more onerous than the individual mandate. With the ACA, you just pay a penalty that year [for being uninsured]. With this, if you drop out of the market, you may be excluded from coverage down the line.”

Thankfully, this piece of legislative genius appears to be stillborn, as illustrated by this Forbes headline of the type guaranteed to send the GOP rank and file into torch-and-pitchfork mode. There’s a quote in the Forbes story that shows the enthusiasm with which the Burr-Hatch-Coburn plan has been received:

“The plan makes specific proposals worthy of serious consideration—although I doubt it receives it at this moment,” says Ronald Williams, the former chairman of Aetna. “Perhaps in the future it could be the foundation of serious conversations which could lead to bipartisan evolution of the current bill.”

Um, yeah. Nice try. Obamacare became the law of the land nearly four years ago—and this junk is the best alternative the GOP can come up with?

Categories: Poking the Hornet’s Nest