The Dark Strategy at the Core of the GOP Health Care Plan
How the House Republican plan to overhaul Obamacare went from repeal-and-replace to cap-and-strangle
The driving principle of Tryancare is to dangerously erode federal support for health insurance over time – both for individual policies bought in the marketplace and for Medicaid recipients.
.. It trades in Obamacare’s guaranteed payouts for a new program of federal spending that looks vaguely adequate in year one. But Tryancare then caps future payouts – at a growth rate far below health care inflation.
.. Tryancare would mail out a monthly refundable tax credit – essentially, a check from Uncle Sam – for Americans to buy their own health plans.
.. Because these are flat tax credits, Tryancare shifts money out of the pockets of the poor and gives it to the upper middle class. A 60-year-old with an income of $20,000 would lose more than half the premium support now paid for by Obamacare (average: $9,874), while a 60-year-old making $75,000, who today does not qualify for subsidies under Obamacare, would get $4,000 under Tryancare.
.. Obamacare provided funds to expand Medicaid from a program generally limited to women and children in poverty to create, instead, universal coverage for the poor and working poor.
.. states would have to pony up an additional $253 billion over the next decade to preserve the benefits of Obamacare’s Medicaid expansion.
.. the Tryancare contribution is capped. It grows only at the rate of the increase in the Consumer Price Index (a measure of inflation) plus one percent.
.. Subsidies climbed from an average of $291 a month in 2016 to $367 in 2017, a boost of $76 a month.
.. Four GOP senators, led by Rob Portman of Ohio, have warned that Tryancare’s changes to Medicaid risk making it a non-starter.