Avik Roy and Ross Douthat were the first two guys I thought to check in order to learn more about the GOP health care plan. (Roy is, of course, well known as a health care wonk, and Douthat is my favorite columnist). Like many others, their reaction is negative.
Here is Avik Roy’s article at Forbes. He mentions that the best part of the bill is its overhaul of Medicaid, but criticizes other parts, such as its failure to repeal most of Obamacare’s insurance regulations because Republicans decided to pass the bill using reconciliation, which can only be used for taxes and spending; the flat tax credit, which creates a disincentive that traps people below the poverty line; the high threshold for phasing out the tax credit, etc. Best quote is at the end:
Expanding subsidies for high earners, and cutting health coverage off from the working poor: it sounds like a left-wing caricature of mustache-twirling, top-hatted Republican fat cats. But not today.
Ross Douthat had a series of tweets that I feel are worth mentioning. First, this:
Then, this series:
He also re-tweeted a decently fair-minded explanation of what Paul Ryan might be thinking – almost, but not quite, a defense – from a surprising source, Matthew Yglesias at Vox.
Finally, Megan McArdle at Bloomberg takes apart the plan – it’s basically Obamacare lite, among other problems – and provides a rather funny line, if you’re in the mood for snark:
I must point out that it’s actually quite clear what problem this bill solves: the problem of Republican legislators who want to tell their base that they repealed Obamacare, just like they promised. Tada!
She also points out that, since it’s not likely to work, the GOP would own any ensuing failures; no longer could they point to Obama and the Democrats as the problem.
As it stands, I’m inclined to doubt it should be passed. Something should be done, but not anything. It needs to be something good; something with enough bipartisan support to pass both the House and Senate. Something that won’t simply get repealed when the Democrats inevitably win an election and return to power. We can’t just keep passing the health care yo-yo back and forth every four or eight years. And it needs to be something that won’t let the Democrats credibly declare the “conservative” plan a failure and therefore show the need for single payer health care.
If I were the GOP leaders, I would seriously consider dropping the philosophical opposition to a mandate as a sort of litmus test for any reform, and begin to tout a plan like Switzerland’s. Republicans get to lower government health care spending, and transform the system from an employer-based system to a private, individual, consumer-driven market, while the mandate, regulations on insurers, and goal of universal coverage could be what entices enough Democrats to support it. That might be a way to get 60 votes in the Senate and change the system for the long term (and avoid single payer).
If that’s not possible, perhaps just go with Cassidy-Collins for the “federalist compromise.”