By now, the insane risk of repealing Obamacare without a replacement plan is pretty well established.
About 21 million Americans would lose their health coverage, a number that would only grow. Premiums would likely double on the individual market. In New Jersey alone, $4.2 billion in federal funds would be lost annually, according to a new report.
People of all political stripes are alarmed, but Republicans still have no replacement to reassure them; just a set of principles that would deeply cut coverage.
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Here's the bottom line: There's no way to cover all these Americans under any of their schemes, or to give people with pre-existing conditions protections.
Millions will lose coverage because the GOP plan will scale back Medicaid, along with the subsidies that make insurance affordable to those buying coverage on the exchanges. To say we can cover all these people at much lower cost sounds too good to be true, because it is. It's a fake.
So is the promise to protect coverage for people with pre-existing conditions. Without the mandate that requires everyone to buy insurance, any rational person would live without it and buy coverage only after getting sick.
As a result, there won't be enough healthy people in the pool to keep the premiums from skyrocketing. So yes, coverage may still exist for people with pre-existing conditions. But that doesn't mean they'll be able to afford it.
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The fact is, you can't protect people with pre-existing conditions without those two basic facets of Obamacare - requiring everyone to buy insurance, and providing subsidies to make sure lower income people can afford it.
Yet the GOP plan would get rid of the mandate and the existing subsidies. Instead, it would give the exact same tax credit to everyone, regardless of income or the cost of health care in your state. As a result, lower and middle-class people will pay a much larger share of their earnings or be unable to afford any coverage.
Republicans would also expand health savings accounts (HSA) that allow people to squirrel away money for their future health needs and get a tax break on it - again, mostly to the benefit of the rich. Because besides being the ones with the upfront money to contribute, the wealthy would profit the most from the tax break.
For 90 percent of the people who gained coverage under Obamacare, this tax benefit would be worth 15 cents or less per dollar saved in the HSA, according to the Center on Budget and Policy Priorities. But wealthier families would get a tax benefit of well more than twice that.
The biggest winners all around are the rich, who currently help finance Obamacare and under the GOP alternative would pay lower taxes. The biggest losers are lower income people, many of whom will be stripped of their health coverage entirely.
The GOP plan would end the Medicaid expansion, part of Obamacare that newly covered hundreds of thousands of lower income people, and convert Medicaid into a per capita cap or a block grant. Either would deeply cut the program over time and leave states solely responsible for any crises that arise, like the opioid epidemic.
So this is literally taking from the poor and giving to the rich. That, in essence, is the Republican replacement plan.
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