The reason I use scare quotes here is that the single-page document the White House circulated this week bore no resemblance to what people normally mean when they talk about a tax plan. True, a few tax rates were mentioned — but nothing was said about the income thresholds at which these rates apply.
.. Meanwhile, the document said something about eliminating tax breaks, but didn’t say which. For example, would the tax exemption for 401(k) retirement accounts be preserved?
.. So if you were looking for a document that you could use to estimate, even roughly, how much a given individual would end up paying, sorry.
.. Trump is like a temperamental child, bored by details and easily frustrated when things don’t go his way; being an effective staffer seems to involve finding ways to make him feel good and take his mind off news that he feels makes him look bad.
Trumpcare 2.0: It’s Even Worse Than the Original
The new version would further tighten the screws on vulnerable Americans by letting insurance companies charge older people and people with pre-existing conditions much higher premiums than they charge younger and healthier people. It would also give insurers the freedom not to cover essential health services like maternity care and cancer treatment.
.. The premium for a 40-year-old earning $30,000 living in Chattanooga, Tenn., would increase by $3,000 under the bill, according to the Kaiser Family Foundation.
.. The AARP says that 40 percent of those between the ages of 50 and 64, or about 25 million people, have the kinds of pre-existing medical conditions that would put them at risk of losing affordable health insurance under the House bill.
.. Republican lawmakers claim that states could help anybody hurt by their bill by creating high-risk pools with the help of federal grants. But this is a disingenuous argument. Many states operated high-risk pools before the A.C.A., but they ran up large losses and benefited few people.
.. A recent Pew poll found that 60 percent of people say that the government has a responsibility to make sure everybody has health care.
Trump’s Renewed Focus on Health Bill Vexes GOP Tax Overhaul Strategy
Mr. Trump signaled last week that one of the reasons he has reprioritized health care is that he was relying on savings from the health bill to bolster the tax plan.
.. If the health plan is signed, “we get hundreds of millions of dollars in savings that goes into the taxes,”
- .. an additional 3.8% tax on high-income households’ investment income,
- an extra 0.9% tax on top earners’ wages and
- various taxes related to health-care, such as medical devices.
.. repealing those taxes and offsetting the effect on budget deficits by cutting Medicaid, the health program for the poor.
.. lower projected federal revenue by about $1 trillion over a decade.
.. Republicans on Capitol Hill worry that they may not be able to adopt a 2018 budget resolution because of intraparty disagreements on spending.
Paul Ryan Failed Because His Bill Was a Dumpster Fire
It was bad policy, not poor tactics or negotiating skills, that doomed the GOP’s efforts to repeal and replace Obamacare.
he and his allies crafted a poorly constructed and radical bill that would sharply cut support to low-income Americans and those with serious health conditions, while enacting big tax cuts for the wealthy.
.. Speaker Ryan’s crafting of AHCA was a slapdash enterprise.
.. even leading health-care experts were confused by the changes. As Timothy Jost noted at Health Affairs: “This comprehensive a repeal of the ACA would have far-ranging consequences for our health care system that can scarcely be described, much less understood, in the hours that remain before a vote.”
.. wondered whether the game plan was just for the House to pass something—anything—and then let the Senate do the real work.
.. So why did Republicans fail? In a word: insincerity.
.. they might have refined another conservative model, such as Avik Roy’s modifications to ACA exchanges, to turn ACA’s exchanges in a more conservative direction.
.. Secure in the knowledge that they would face President Obama’s veto, Republicans rammed through a succession of extreme repeal-and-replace bills that resembled AHCA’s original draft. These bills excited the Republican base, but would have horrified most other Americans if they ever found sufficient reason to look.
.. Congressional Republicans suffered what George W. Bush might call a “catastrophic success” with Donald Trump’s unexpected victory.
.. leaving people in plans where the “deductibles are so high that it’s really not worth much to them.”
.. He vowed to replace the “failing,” “horrific” Obamacare with “something terrific.”
.. Republican plans are designed around higher deductibles and narrower benefits, not to mention more limited Medicaid.
.. smaller financial subsidies for people with chronic health conditions. That was the clear intention, but Ryan refused to admit it.
.. Many in the GOP, above all President Trump, seemed strangely uninterested in the policy details.
.. To the extent Republicans did have an animating passion, it was to puncture President Obama’s legacy—and to avoid looking foolish by failing to honor their “repeal and replace” rhetoric.
.. For all their endless warnings about how Obama’s signature health law was hurting American families, driving up costs and putting us on the path toward socialism, it turns out they didn’t care enough to put in the work.