After seven years of promising to repeal and replace Obamacare, Republicans finally have a plan. If only we had held our breaths during all that time, they could have skipped it. We'd all be dead.
Will it lower individual cost and provide better coverage? Hopefully. However, it falls well short of providing free-market coverage. The only way to do that is to repeal Obamacare and get out of the way – something Democrats are adamantly against and timid Republicans are reluctant to do.
Americans are generous people and would never abandon the poor to charity or, horrors, leave that responsibility to their families. In our "me-first" society, it's just too much to expect people to take care of their own. Nevertheless, what we desperately need is a two-tier system: One for the poor where there are special government-run, low-cost, bare-bones centers that provide basic emergency care, and one for all the rest who must pay their own way.
Yes, health care costs something. If our government would simply take care of those who truly cannot take care of themselves and get out of the way, we would have a free market that would offer more choices than we could imagine and all levels of coverage. The average person could easily find one that fits his or her need and pocketbook.
In the current climate that simply will not happen. Too many Americans have become too dependent for far too long. Obamacare sealed the deal, and now these freeloaders want everything for nothing or next to nothing, which is what most hardworking, taxpaying Americans have received under the unAffordable Care Act. These Americans were forced to pay high premiums for a plethora of services they didn't want and would never use, with deductibles so high it was virtually useless.
Republicans, to their credit, have sought to level the playing field a bit by giving some of these Americans tax credits to offset the cost of their premiums, which will still be higher than they should be.
Nevertheless, there are some good points to the plan that will now go through the committees and is open to amendments.
The Good: You will be able to buy insurance with a pre-existing condition, but you will not be able to wait until you really need it, without paying a penalty. Your premium will not be surcharged as long as you get in the insurance market and stay in.
The Bad: The surcharge is only for one year.
The Ugly: Many people likely will opt to wait because the surcharge is set at 30 percent. They may weigh the cost of the higher premium and decide, what the heck, for one year it is worth it. I'd rather spend that money now on a new car or iPhone.
The Good: The people that were covered under Obama's Medicaid expansion can remain indefinitely, providing they remain eligible. Medicaid will be changed from an entitlement to a per capita payment sent to the states. Those states that did not expand Medicaid under Obamacare will receive $10 billion over five years to use as they see fit.
The Bad: This may cause those covered under the Medicaid expansion to forgo work so they will not lose their free health care.
The Good: People who received subsidies under Obamacare will continue to receive them through 2019. Hopefully, they will use them to purchase better coverage with expanded options. These subsidies will be replaced by tax credits.
The Bad: Those getting insurance virtually free will scream bloody murder because they will have to pay something.
The Ugly: That's life.
The Good: Young people will be able to remain on their parent's insurance plan through age 26.
The Bad: This drives up the cost for those 27 and older, because they have to subsidize these younger adults.
The Good: Obamacare was designed so that younger people, who can least afford it, would subsidize older, more affluent Americans. The Republican plan will level the playing field a bit.
The Bad: It's not enough.
The Good: Eliminates funding for Planned Parenthood.
The Bad: It's only for one year.
Best: Expands the allowable size of health care savings accounts that can be coupled with high-deductible insurance plans. This is the most effective way to empower patients and drive costs down.
The reality is that the good in this bill is not what we need. We must accept the fact that we simply are not going to get "great" at this time, if at all. Unfortunately, the longer we wait, the more difficult it will be to repeal Obamacare.
Media wishing to interview Jane Chastain, please contact [email protected].
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