John Kasich explains the part of Obamacare he’d keep

19 Aug 2015 | Author: | No comments yet »

Bobby Jindal Blasts Scott Walker’s Health Plan As Too Liberal.

Very near the beginning of Scott Walker’s new proposal to “repeal and replace” the Affordable Care Act, he bemoans that Obamacare forced so many people to give up the insurance they once had.

BROOKLYN CENTER, Minn. (AP) — Republican presidential candidate Scott Walker on Tuesday offered an alternative to President Barack Obama’s health care law that would provide tax credits and restructure Medicaid, and took a swipe at GOP rivals in Congress for their inability to repeal the law. “I’m willing to stand up against anyone, including members of my own party,” Walker said at Cass Screw Machine Products in suburban Minneapolis. “I’m willing to stand up against anyone to get the job done.” Walker’s proposal calls for repealing the law immediately and replacing it with a plan that gives states more power to operate Medicaid, ties refundable tax credits to age rather than income, and shifts to discretion of states the decision on whether to offer the popular Obama provision that currently allows people up to age 26 to remain on their parents’ insurance plans.In an effort to regain control of his campaign messaging, Wisconsin Governor Scott Walker unveiled the outline for what he has called one of his top priorities, repealing and replacing Obamacare. “We’ve got a plan, it’s simple to begin with, it’s as simple as this,” Walker said to a group of invited guests at a Minnesota machine shop. “It starts out with the premise that on my very first day as President of the United States, I will send legislation to the Congress to once and for all repeal Obamacare entirely.” In his remarks, Walker took aim squarely at Democratic frontrunner Hillary Clinton, saying that Clinton “had a much bigger vision and a much bigger goal than just what we see under Obamacare.” Similar to Obamacare, Walker’s plan provides tax credits for people not insured by their employer.

Walker, the Republican governor of Wisconsin and one of many GOP presidential hopefuls, then goes on to outline an alternative plan that would do the exact same thing. There are differences in specifics: the insurance exchanges are now called pools, where small businesses can band together to buy coverage for employees; young adults can stay on their parents’ plans but only if states OK it; and Americans without job-based insurance would qualify for government subsidies based on age instead of income. It promotes benefits like less regulation and less federal spending on health insurance, as well as cheaper coverage for some young and healthy people. Walker detailed his plans with a slide presentation that mixed policy and politics, seeking both to distinguish himself from Republicans who have failed to eliminate Obama’s law, such as Sens. Bobby Jindal (R), for not offering a sufficiently conservative alternative. “Republican leaders in Washington told us during the campaign last year that we needed a Republican Senate to repeal Obamacare.

Walker also proposes allowing people to buy insurance across state lines, increasing the contribution limits on tax-free Health Savings Accounts, and incentivizing HSA’s with a $1,000 tax credit. Under Walker’s plan, Taylor Swift would get $1,200 to help buy coverage because she’s 25, while Obamacare would give her nothing on the grounds that she’s superrich. And there are some conservative ideas in the mix too: states would run more of the program, insurance regulations would be scaled back or scrapped and medical malpractice lawsuits would be limited. But like all the other Republican “repeal and replace” plans that have appeared in the last few years, Walker’s proposal never acknowledges the trade-offs and consequences of these changes. But overall, the plan reflects a reluctant realization that there are few alternatives to fix many of the problems that Obamacare addressed and that after two Supreme Court decisions, a presidential election and two midterms, the law will be hard to completely upend. “On paper, it certainly does provide protections.

But the criticism misses the political and institutional reality: Republicans hold 54 Senate seats, short of the 60 needed to break a filibuster, and Obama can veto legislation. Americans want more than campaign promises, they want results.” Walker’s plan — titled “The Day One Patient Freedom Plan” — is a patchwork of recycled health care proposals that various Republicans have put forth over the years, none of which the party has been able to coalesce around in Congress. Walker says his plan would remove the current mandate that everyone purchase insurance, but still protect Americans with pre-existing conditions through unspecified additional reforms. There are just some holes,” said Larry Levitt, a senior vice president at the non-partisan Kaiser Family Foundation, which has studied the law extensively. There’s a pretty significant gap between campaigning against the president’s signature law and governing with it in place, and talking points — no matter how appealing they sound — often don’t meet up with reality.

Walker’s plan does not include cost figures or an estimate of the number of people who would be covered, making it nearly impossible to compare with current law. According to the latest Gallup survey, the rate of people without insurance dropped six percentage points, to just 11.4 percent since key Obamacare provisions began in 2013— the lowest since tracking began in 2008. If enacted with as little as oversight as outlined, Walker’s plan would likely lead to coverage at levels even lower than pre-Obamacare. “At the talking point level, Governor Walker’s plan sounds an awful lot like Obamacare,” Levitt said. Look a bit deeper, though, and “there are some big differences.” For instance, the popular prohibition against denying coverage to individuals with chronic conditions such as cancer only is in place if the patient had maintained continuous insurance.

Obama experienced the consequences of this in the fall of 2013, when insurers canceled policies that didn’t conform to the new law’s regulations — thereby violating Obama’s oft-repeated pledge that “if you like your plan, you can keep it.” Any White House hopeful seeking a better understanding of how bruising it is to carry out big changes to health policy need only ask the building’s current occupant. Obamacare isn’t overwhelmingly popular, but it’s now integrated into the health care system and has been responsible for a historic expansion of health insurance coverage.

Topher Spiro, vice president for health policy at the Center for American Progress, a think tank often aligned with the White House, said Walker’s plan would be a step backward. A new CNN/ORC poll out Tuesday morning showed his support drop to just eight percent, tied for fourth place nationally behind Trump, Jeb Bush, and Ben Carson. “But I hope you’ve seen here not just in Minnesota, but across America, I think like you think. We need to see who will win and who will lose under Walker’s plan.” Walker isn’t the first Republican to put forward a detailed plan for replacing Obama’s law.

By rolling back Obamacare’s new spending and regulation, both of which Republicans oppose on ideological principle, any GOP “replacement” proposals would almost certainly leave people far more exposed to crippling medical bills. It would no longer require insurance plans to cover a core set of benefits (Obamacare has a set of “essential benefits,” including preventive care and pregnancy costs, that insurers must cover). This would likely mean the benefits available to people buying their own coverage would become cheaper — since they cover fewer services — but also less robust.

Jindal criticized Walker’s plan for the age-based tax credit for those who don’t have insurance through their employer, calling it “Obamacare lite.” “In a health care plan that is light on specifics, Governor Walker endorsed the fundamental underpinning of Obamacare – the notion that America needs another entitlement program,” Jindal said in a statement. But with this Obamacare lite health care proposal, he’s going to have to drop those lines from his speech.” Piling on further insult, a staffer with Jindal’s campaign reportedly said they suspected Walker “collaborated on [his plan] with Bernie Sanders,” the Vermont senator and self-described democratic socialist who is running for president as a Democrat. Tax credits would be even for all Americans, regardless of income; that benefits wealthier Americans who don’t need the help. “If you’re making $150,000, you’re getting the tax credit. In actuality though, Republican plans to block grant Medicaid universally make significant cuts to the program — cuts that experts say can’t just happen by making the program more efficient.

A world in which Obamacare is repealed, and the Walker plan enacted, is one in which the individual market is friendlier to higher-income, healthy shoppers — but likely worse for the poor and the sick, both those seeking private coverage and those on Medicaid. In 2010, he also called for tax credits so people wouldn’t be “faced with either government-run Medicaid or emergency rooms or being uninsured.” Jindal’s current health plan, by contrast, would give individuals tax deductions in order to encourage them to purchase insurance. It seems safe to assume that insurers would start charging older Americans much higher premiums for comprehensive coverage, or simply stop offering such policies altogether.

Walker’s replacement plan would require states to pick up the slack, but state Legislatures do not meet year-round and there’s no guarantee that even Republican-led statehouses would rush to set up a healthcare system based on Washington’s offers. “If the federal government put the responsibility for regulating insurance and creating new programs back on the states, it would take time to put those in place. Every state Legislature would have to go through a debate about what kinds of rules they wanted in the insurance market,” Levitt said. “We’re talking about several years, even if the law based on this plan were to pass.” Walker’s plan also is likely to face opposition from the healthcare industry. After years of preparation and adjustments to comply with Obamacare, yet another fundamental shift is hardly one they—and their shareholders—are going to embrace. And while Obamacare also offers lower-income people additional financial assistance that reduces out-of-pocket costs, Walker’s plan calls for no such protection.

Instead, it would provide more tax incentives for setting aside money in “health savings accounts” — a form of tax-preferred savings that people can use to cover medical expenses. This would tend to work out well for some middle- and upper-income people, because right now they don’t qualify for much — or any — financial assistance for the government. And therein lies the problem with Walker’s and Rubio’s and Jindal’s plans, which have nothing to do with their substance: When in power, Republicans have never made a strong push to enact those plans.

This was true in the 1990s when the GOP fought President Bill Clinton’s reforms, it was true after 2010 when they took over the House and it’s been true since last year when they took over the Senate.

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