There are many good arguments to be made in favor of Trumpcare, but this is not one of them.
Of all the arguments to make for repealing and replacing Obamacare, the very worst is that people don’t need health insurance.
.. Sean Spicer told reporters last week, “When we get asked the question, ‘How many people are going to get covered?’ that’s not the question that should be asked.” Pressed on the merits of the bill by George Stephanopoulos on ABC’s This Week, Office of Management and Budget director Mick Mulvaney shot back, “You’re worried about getting people covered.” As if that’s a woeful mistake. This is a strange rhetorical tack for officials in an administration led by a president who pledged to cover everyone.
.. But the best response to criticisms that Trumpcare doesn’t cover enough people is simple and more fundamental — to get the coverage numbers up.
.. The arguments that they are making in public are the kinds of things you might have expected to hear at a private fundraiser of the sort that undid Mitt Romney when he famously dismissed “the 47 percent.”
‘Is that not correct?’: Male GOP lawmaker asks why men should pay for prenatal coverage
The law also required plans to cover pregnancy and childbirth. That’s where the fireworks started in the Energy and Commerce Committee.
“What mandate in the Obamacare bill does he take issue with?” Doyle asked Shimkus, using the formal parlance of congressional committees.
“What about men having to purchase prenatal care?” Shimkus said.
At that point, one could hear the room start to stir.
“I’m just . . . is that not correct?” Shimkus said. “And should they?”
.. “Do men not have to buy maternity coverage?” Ellmers said, referring to the health-care law’s essential health benefits. “To the best of your knowledge, has a man ever delivered a baby?”
Here’s how insurance expert and columnist Nancy Metcalf answered a similar question from a Consumer Reports reader that year:
Health insurance, like all insurance, works by pooling risks. The healthy subsidize the sick, who could be somebody else this year and you next year. Those risks include any kind of health care a person might need from birth to death — prenatal care through hospice. No individual is likely to need all of it, but we will all need some of it eventually.
CBO Sees 24 Million More Uninsured, $337 Billion Deficit Cut in Coming Decade With GOP Health Plan
Drop in number of insured would result in part because people would opt to go without coverage
The report, by the CBO and the Joint Committee on Taxation, said the number of insured would drop in part because of people opting to go without coverage once the requirement that most Americans have coverage or pay a penalty is repealed. Higher premiums would also prompt some people to opt to go without insurance.
.. Premiums in the individual market would tend to increase before 2020, rising up to 20% higher than under the ACA, in large part because of the demise of the penalty for not having coverage, based on the report. Premiums would then go down: In 2026, the average premiums for a single person in the individual market would be about 10% lower than under the health law now, the analysis found.
.. Republicans have been pitching their overhaul of the health law as a cure for high prices under the ACA, asserting that the proposal would drive down costs by encouraging competition and giving people more choice. To achieve that, GOP members aim to relax the requirement that insurers provide a certain array of benefits, allowing them to offer less generous plans that cost less, among other changes... The ranks of the uninsured would rise by 24 million in a decade in part due to a decline in the number of people on Medicaid, according to the CBO analysis. In 2026, an estimated 52 million people would be uninsured compared with 28 million who would lack insurance under the current ACA.
Donald Trump is about to face a rude awakening over Obamacare
But at the end of the day, once you decide that everyone, regardless of age or medical condition, should be able to buy health insurance at an affordable price, you have essentially bought into the idea that young and healthy people have an obligation to subsidize the older and sicker people in some fashion. And once you do that, it’s sort of inevitable you end up where every health reform plan has ended up since the days of Richard Nixon. You end up with some variation on Obamacare.
.. There are no easy solutions here, no free lunches. You can’t have all the good parts of an unregulated insurance market (freedom to buy what you want, when you want, with market pricing) without the bad parts (steadily rising premiums and insurance that is unaffordable for people who are old and sick).