Republican Health Care Reform Plans Are Getting Less Comprehensive And Less Acceptable

To borrow a line from Hamilton, the musical, [Republicans are having their] "governing is harder moment" with health care reform. Just this week they added two more health care reform proposals (outlines) to the seven they conjured up since 2009. The latest health care proposals are near opposites of each other and include an Affordable Care Act (aka Obamacare) light plan and a worse than before Obamacare plan with no subsidies, or possibly, insurance for the sick and poor.

The Road To Still No Health Care Reform Bill

Whenever Obamacare opponents provide an Obamacare alternative plan, its contents are 90% Obamacare is an abject failure, and 10% (usually a bulleted list), here's my plan. Because the focus is not on reforming America's complex and pricey health care and health insurance sectors, their plans come up short in money, benefits covered and access, when compared to Obamacare. This opposition-focused exercise that Republicans are engaged in has produced nine proposals so far.

  • The Obamacare Replacement Act
  • Patient Freedom Act
  • The American Health Care Reform Act
  • The Patient Choice, Affordability, Responsibility, and Empowerment (CARE) Act
  • Health Care Choices Act
  • A Better Way, To Fix Health Care (Reform Plan)
  • The Patients' Choice Act
  • Health Care Freedom Act
  • Empowering Patients First Act
So, from 2009 to 2017, Republicans have been unable to agree on a unified health care reform plan. But this week they are meeting in my hometown of Philadelphia to map out their policy agenda. According to leaked photocopies of the retreat agenda, there was a Thursday morning session labeled Keeping Our Promise On Health Care. And unless some waiter recorded this session, we probably won't know for some time what Republicans plan to do with American health care. Will they agree on a unified reform proposal—there's no shortage of them, including the two announced just this week? Will they, as Trump mused, wait to see if Obamacare explodes and then "rush" to fix it in 2018, after the mid-term elections? Or will they propose a series of health care reforms stretched out over several years? And will these reforms be more health care or health insurance-centric?

More Words Don't Equal More Coverage

Republicans' Obamacare replacement plans are all over the map. Some focus on health care and health insurance reform together, others one or the other. At first glance, they seem to be growing further apart. But look closer at the latest alternative from Senator Rand Paul, the Obamacare Replacement Act, and you may find several similarities to the plan Congressman Tom Price, proposed in 2009. The Secretary of Health & Human Services nominee, Price, is credited with proposing one of the most comprehensive Obamacare alternative plans, the Empowering Patients First Act. Paul's plan is short on details, but he and Price have the same or similar philosophy about American health care policy. The Acts similarities are notable. For one, both authors are physicians, but the similarities don't stop there.

  • Promote Health Savings Accounts to help with the purchase of insurance and health care
  • Favor the rich and healthy
  • Offer a lot less assistance to the poor and sick (compared to Obamacare)
  • Look to reduce or equalize tax incentives for employer health insurance plans
  • Promote health insurance pooling via association health plans
  • Propose state-run high-risk pools
There are, of course, significant differences between the Acts, the main one being Paul's plan provides no subsidies to anyone to purchase health insurance.

What Now?

It's not surprising that two doctors, one representing the House and the other the Senate, created Obamacare alternatives that focus on health care and not so much on health care access. If you can afford to pay for your health insurance with no or very minimal assistance, these plans are okay, if you can't, these plans are horrible. A medical degree is not a health care economics degree, and these doctors prove they don't have the expertise or desire to address economic issues. So round and round we go with Republican health care reform plans. They've gone from stingy to nothing at all. But that's not their only strategy. They are hoping that while they pretend like they have a solution to the country's out of control health care prices, Obamacare does explode and people will accept nothing in exchange for abandoning health care reform. It won't be that easy.
blog comments powered by Disqus