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News Health Care Wednesday, Aug 19 2015

Sorry, Scotty, No One's Impressed By Your Health Care Plan

Aug 19, 2015

Scott Walker isn’t winning any friends after releasing his “new” (read: same old GOP plan as always) health care “plan” (read: a couple of bullets). Quickly falling behind Donald Trump in Iowa, Walker’s half-cooked policy paper is a desperate attempt to win back some momentum, but by the looks of the headlines, that’s unlikely to happen.

Los Angeles Times: Michael Hiltzik: Walker’s healthcare plan is perfect, if you want almost no insurance at all

In short, every nostrum promoted by the conservative and libertarian lobbies (the Heritage Foundation is cited several times), none of which has been shown to make much of a dent in the nation’s population of the medically uninsured and a few of which would work against that goal, is in there.

To be fair, Walker threw in a couple of novel curves. Let’s take them up first. The most notable is a provision to convert the income-based premium subsidies provided under the Affordable Care Act to a system based on age. According to Walker’s breakdown, the subsidies would range from $900 a year for those 0-17 years old, up to $3,000 for those 50-64. The payments are only for those without employer-sponsored insurance.

Of Walker’s more conventional proposals, the big cheese is selling health policies across state lines. This is a hardy perennial for the GOP–it was part of John McCain’s presidential platform in 2009, but you have to search far and wide to find a single credible healthcare expert who thinks it’s a good idea. Larry Levitt of the Kaiser Family Foundation told Bloomberg News, “if you allow the sale of insurance across state lines with no minimum federal rules, insurers would gravitate to states with little regulation.”

So if you want to buy health insurance with no standards whatsoever, Walker’s your man.

Vox: Scott Walker’s Obamacare replacement plan, explained in 500 words

For high earners, this might be great. 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. For lower-income people, this is a lousy deal: A 25-year-old earning $17,000 at a low-wage job would get a $1,962 credit under Obamacare.

Walker’s plan says it would “protect all Americans with pre-existing conditions,” but when you read the fine print, you realize that’s not accurate. It would only bar preexisting conditions for Americans who have continuous coverage — who never have a lapse between their plans. But there aren’t any protections mentioned for people who do drop coverage at some point. This group is big: One study found that between 2004 and 2007, 89 million Americans had at least a one-month gap in coverage.

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.

MSNBC: When a health care plan isn’t really a health care plan

Like every other GOP reform plan, Walker’s pitch includes all the predictable clichés – tort reform, high-risk pools, insurance sales across state lines, HSA expansion – that serve as staples of every Republican scheme. It also includes some (very) modest subsidies, which vary based on age, not income.

Is the plan any good at providing health security? For some, maybe – if you’re wealthy, healthy, and have no intention of ever seeking medical care, Scott Walker’s vision of health care reform would very likely meet your needs quite well.

But for everyone else, this plan is almost dangerously misguided.

For example, when Walker talks about “repealing Obamacare,” he’s not just nibbling around the edges – the far-right governor intends to eliminate every benefit that millions of families are currently enjoying. Practically every consumer protection, every tax break, and every safeguard would simply cease to be – regardless of efficacy or popularity.

In its place, American consumers would left with something vastly worse. Protections for those with pre-existing conditions would be severely weakened. Subsidies for private coverage would be paltry and ultimately useless. Untold millions would lose the security they currently enjoy, all in the name of “freedom.”

Because the fact of the matter is, there simply aren’t enough rich, healthy families in the nation to rally behind plans like these. If Americans ever took a good, long look at the Walker and Rubio plans and voted accordingly, the GOP candidates would lose every state.

TIME: Scott Walker’s Obamacare Replacement Sounds Familiar

Yet Walker includes some of Obamacare’s most popular provisions, such as guaranteeing access to health insurance to all Americans. “In the very broad brushstrokes, that’s also what Governor Walker’s plan does. The similarities end there,” said Topher Spiro, a former Capitol Hill senior aide who helped lawmakers write Obamacare.

For instance, older and poorer Americans would be treated less fairly under Walkercare than under Obamacare. 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. It’s not very efficient. It’s very wasteful,” said Spiro, now at the liberal Center for American Progress.

Milwaukee Journal Sentinel: Here’s why Walker’s insurance plan is not bold

Walker’s plan, while big on repeal, appears to be short on the replacement.

Walker said his plan would be paid for by eliminating $1 trillion in taxes that are levied under the current law and by making other changes to Medicaid and how health insurance is taxed. The plan also would take steps to limit medical liability lawsuits by injured patients or family members, a goal that he pursued in Wisconsin.

Walker called his plan bold. It’s not.

It’s early in the campaign, but Walker already has lost a lot of steam. Going after Obamacare is not really bold in my opinion unless you really have a plan that works for the people. A bolder plan from a Republican would be to find ways to beef up the Affordable Care Act to ensure that people don’t go broke or lose their life savings over a medical emergency.

Huffington Post: Scott Walker And The Trouble With Obamacare ‘Replacement’ Plans

By scrapping President Barack Obama’s 2010 health care overhaul, Walker’s plan — which the governor announced this week — would take away health coverage from some unknowable share of the millions of people who have gained it under Obamacare. It promotes benefits like less regulation and less federal spending on health insurance, as well as cheaper coverage for some young and healthy people. 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.

The Republican 2016 contenders want voters to believe things will be different this time, that Obamacare will be easier to repeal and replace than it has been thus far, and that GOP leaders care enough about health care to go beyond vilifying Democratic policies and put some of their own in place. If history is any guide, voters eager for that outcome will have to go on waiting.

New York Magazine: Scott Walker, Marco Rubio Propose ‘Plans’ to Replace Obamacare

Today, Scott Walker and Marco Rubio have published plans — really, not so much plans as skeletal descriptions of planlike concepts — to replace Obamacare. Their fundamental dilemma is that Obamacare provides a popular benefit to millions of voters. Appealing to the conservative base demands they eliminate the program that provides this benefit. Appealing to the general election requires them to promise something to compensate the victims of repeal. How will they fund that something? This is the basic problem that for decades has prevented Republicans from offering a health-care plan. Rubio and Walker show that they still have no answer.

It is tempting to treat the lack of specifics in the Republican health-care plans as a problem of details to be filled it. But it is not a side problem. It is the entire problem. They will not finance real insurance for the people who have gotten it under Obamacare, nor will they face up to the actual costs they’re willing to impose on people. The party is doctrinally opposed to every available method to make insurance available to people who can’t afford it. They have spent six years promising to come up with an alternative plan, and they haven’t done it, because they can’t.

Published: Aug 19, 2015

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