House Republicans roll out plan to screw you

Paul Ryan and his co-conspirators have been talking for years now about their plan to repeal and replace the Affordable Care Act, as soon as they get around to figuring out what that will be. They couldn't figure that out, however, because the ACA is actually working quite well and health care spending has actually grown more slowly than predicted even as the uninsured population has been cut in half. People have discovered that there has not, in fact, been a government takeover of health care and that there aren't any death panels either.

So now Ryan has issued a document which he claims is his replacement plan although it doesn't have any cost estimates or legislative language. Here's how he proposes to make the world better.

Medicare would be replaced by "premium support," meaning old folks would get money with which to buy private health insurance. Note that right now, Medicare is much more cost-effective than private insurance, because it spends far less on administrative costs and marketing, and nothing on profits for shareholders or multi-million dollar compensation packages for executives. So the insurance would be more expensive and presumably the amount government would spend would be less. So if Granny doesn't have big bucks in her 403B, she won't be able to afford comprehensive insurance.

They'll repeal the Medicaid expansion and turn Medicaid into a block grant rather than an entitlement. "Reforming Medicaid’s financing with a per-capita allotment certainly will reduce federal spending," the document says. Right. In other words fewer people will be covered and their benefits will be reduced. Or, as they explicitly say, "Under the House Republican plan, states could also “charge reasonable enforceable premiums or offer a limited benefit package” and use “waiting lists and enrollment caps” for certain groups of Medicaid beneficiaries."

There will no longer be a requirement that people have health insurance. This means, of course, that young and health people won't be in the risk pool and insurance will get more expensive for everybody else.

Insurers won't have to cover pre-existing conditions if you haven't been continuously insured. That pretty much leaves us where we were before.

There's more, but the basic idea is to make things worse for everybody who isn't well to do. Exactly why this is supposed to be better than what we have now they do not explain, but I will tell you: it will enable tax cuts for rich people.