Why there is No Republican Plan to Replace Obamacare

Seymour Flops

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None with a chance to succeed, anyway. There have been some plans offered that never went anywhere.


Published: Sept 18, 2017

In 2017, President Donald Trump and Republicans in Congress unsuccessfully pursued several efforts to repeal and replace the Affordable Care Act. How did their replacement proposals compare to the ACA? How did they compare to each other?

Plans available for comparison:


  • Graham-Cassidy-Heller-Johnson Amendment – Updated 9.25.17 (PDF)
  • The Health Care Freedom Act, 2017 (PDF)
  • The Better Care Reconciliation Act of 2017 (PDF) – Updated 7.20.17
  • Obamacare Repeal Reconciliation Act of 2017 (PDF)
  • The Better Care Reconciliation Act of 2017 (PDF) – Updated 7.13.17. Includes Cruz amendment.
  • The American Health Care Act, as passed by the House of Representatives on May 4, 2017 (PDF)
  • The Affordable Care Act, 2010 (PDF)

The problem is this:

Any Republican plan to "replace Obamacare" would have to be a plan very much like Obamacare, but which follows Republican principals. Those are contradictory requirements that cannot be simultaneously fulfilled.

We have to remember what Obamacare is in both purpose and design. Jonathan Gruber gave the only honest answer by drunkenly saying the quiet part out loud (more than onece):

It is a scheme to transfer wealth from the healthy to the unhealthy. The healthy pay far larger premiums in order for insurance companies to survive the requirment that they accept patients already sick with expensive maladies.

What Gruber left out is that much of the funding to the unhealthy comes from borrowed money and printed money used for the subsidies. The overwhelming majority of the marketplace premiums are paid for by government, not the individual.

The current healthy taxpayer/policy purchaser pays a large part of the burden, but the rest will be borne by most of the grandchildren of the healthy and by some of the grandchildren of the unhealthy.

Another plan that accomplishes that wealth transfer cannot follow expressed (if not followed) Republican principals like low taxes, fiscal responsibility, freedom of choice, and individual responsibility.

The solution to Obamacare is no Obamacare so we can go back to the far lower premiums and freedom of choice that existed prior to that legislation being passed under a cover of lies. There is not the political will to repeal it, and probably never will be.

Most voters and nearly all politicians prefer pain later to pain now. As Keynes himself taught us, "In the long run we are all dead." Not our grandchildren or their grandchildren, of course, but Keynes at least is dead and thus safe from the economic disaster his policies are sure to lead to.

So, the Republicans can do nothing but tweak Obamacare to get rid of the worst of its worst excesses. Allowing the COVID Suplementary Subsdies to expire as provided for by those who voted them in is a baby step in that direction. So is barring illegal aliens who were granted "a legal status" en masse by the previous administration from the subsidies and from Medicaid.
 
As it currently stands, if a poor/homeless person were to stumble into any public hospital, the hospital is "required" to stabilize his/her/its condition. Once stable they can and will release him/her/it.
What the government shouldn't fund for are those who go into a hospital emergency room (operative word, emergency) with colds, mild cases of the flu, sprains, headaches, minor cuts and drug seeking addicts. Those people, with the exception of the drug seeking addict, need to purchase items from their local drug store. Aspirins/Tylenol for their pain, Ace Wraps for their sprain, Dayquil/Nyquil for their colds and mild cases of flu and Bandaids or wraps for their minor cuts. Doing this would empty out a lot of emergency rooms. Emergency rooms are supposed to be for just that, actual life-threatening emergencies. All else should go to one of those doc-in-a-box locations.
 
None with a chance to succeed, anyway. There have been some plans offered that never went anywhere.


Published: Sept 18, 2017

In 2017, President Donald Trump and Republicans in Congress unsuccessfully pursued several efforts to repeal and replace the Affordable Care Act. How did their replacement proposals compare to the ACA? How did they compare to each other?

Plans available for comparison:


  • Graham-Cassidy-Heller-Johnson Amendment – Updated 9.25.17 (PDF)
  • The Health Care Freedom Act, 2017 (PDF)
  • The Better Care Reconciliation Act of 2017 (PDF) – Updated 7.20.17
  • Obamacare Repeal Reconciliation Act of 2017 (PDF)
  • The Better Care Reconciliation Act of 2017 (PDF) – Updated 7.13.17. Includes Cruz amendment.
  • The American Health Care Act, as passed by the House of Representatives on May 4, 2017 (PDF)
  • The Affordable Care Act, 2010 (PDF)

The problem is this:

Any Republican plan to "replace Obamacare" would have to be a plan very much like Obamacare, but which follows Republican principals. Those are contradictory requirements that cannot be simultaneously fulfilled.

We have to remember what Obamacare is in both purpose and design. Jonathan Gruber gave the only honest answer by drunkenly saying the quiet part out loud (more than onece):

It is a scheme to transfer wealth from the healthy to the unhealthy. The healthy pay far larger premiums in order for insurance companies to survive the requirment that they accept patients already sick with expensive maladies.

What Gruber left out is that much of the funding to the unhealthy comes from borrowed money and printed money used for the subsidies. The overwhelming majority of the marketplace premiums are paid for by government, not the individual.

The current healthy taxpayer/policy purchaser pays a large part of the burden, but the rest will be borne by most of the grandchildren of the healthy and by some of the grandchildren of the unhealthy.

Another plan that accomplishes that wealth transfer cannot follow expressed (if not followed) Republican principals like low taxes, fiscal responsibility, freedom of choice, and individual responsibility.

The solution to Obamacare is no Obamacare so we can go back to the far lower premiums and freedom of choice that existed prior to that legislation being passed under a cover of lies. There is not the political will to repeal it, and probably never will be.

Most voters and nearly all politicians prefer pain later to pain now. As Keynes himself taught us, "In the long run we are all dead." Not our grandchildren or their grandchildren, of course, but Keynes at least is dead and thus safe from the economic disaster his policies are sure to lead to.

So, the Republicans can do nothing but tweak Obamacare to get rid of the worst of its worst excesses. Allowing the COVID Suplementary Subsdies to expire as provided for by those who voted them in is a baby step in that direction. So is barring illegal aliens who were granted "a legal status" en masse by the previous administration from the subsidies and from Medicaid.
Because the American healthcare system is a fucked up idea and you don't have anyone with two brain cells to sort it out. That's why healthcare in many third world countries is better.
 
As it currently stands, if a poor/homeless person were to stumble into any public hospital, the hospital is "required" to stabilize his/her/its condition. Once stable they can and will release him/her/it.
What the government shouldn't fund for are those who go into a hospital emergency room (operative word, emergency) with colds, mild cases of the flu, sprains, headaches, minor cuts and drug seeking addicts. Those people, with the exception of the drug seeking addict, need to purchase items from their local drug store. Aspirins/Tylenol for their pain, Ace Wraps for their sprain, Dayquil/Nyquil for their colds and mild cases of flu and Bandaids or wraps for their minor cuts. Doing this would empty out a lot of emergency rooms. Emergency rooms are supposed to be for just that, actual life-threatening emergencies. All else should go to one of those doc-in-a-box locations.
Yes, that is a problem, but care like OTC pain meds and ace wraps will not break a hospital.

My question is how do people with cancer, heart conditions, strokes, etc. get healthcare?

If they have never paid into health insurance, they can simply sign up for a policy once they realize they need one. Paid for by taxes, borrowed and printed money, and the artificially high premiums of the young and healthy forced to have them.
 
Because the American healthcare system is a fucked up idea and you don't have anyone with two brain cells to sort it out. That's why healthcare in many third world countries is better.
Then why did people from third world countries stream across our border after Biden opened it up?
 
As it currently stands, if a poor/homeless person were to stumble into any public hospital, the hospital is "required" to stabilize his/her/its condition. Once stable they can and will release him/her/it.
What the government shouldn't fund for are those who go into a hospital emergency room (operative word, emergency) with colds, mild cases of the flu, sprains, headaches, minor cuts and drug seeking addicts. Those people, with the exception of the drug seeking addict, need to purchase items from their local drug store. Aspirins/Tylenol for their pain, Ace Wraps for their sprain, Dayquil/Nyquil for their colds and mild cases of flu and Bandaids or wraps for their minor cuts. Doing this would empty out a lot of emergency rooms. Emergency rooms are supposed to be for just that, actual life-threatening emergencies. All else should go to one of those doc-in-a-box locations.
And they need to pay for it, "out of pocket," meaning that THEY pay for it, not insurance, not the government.
 
Because the American healthcare system is a fucked up idea and you don't have anyone with two brain cells to sort it out. That's why healthcare in many third world countries is better.
It's not better.
The "take two aspirins and call in the morning" might be cheaper, but total care is usually worse. Unless you can pay for the better private provided care.
 
Health insurance is high because we have too many obese people that drink, smoke, do drugs, eat junk food and don't exercise.
 
Just repeal it. No replacment.
Yes the Billionaire MAGA plan is for you to die in the street, preferably after having declared bankruptcy because the medical bills you incurred taking care of mom have literally killed you.

We are the only nation in the developed world to have this. We are also the only nation in the developed world to have statistically all wealth owned by billionaires.

But its ok. The BOOMERS have Medicare. **** everyone else.
 
Yes the Billionaire MAGA plan is for you to die in the street, preferably after having declared bankruptcy because the medical bills you incurred taking care of mom have literally killed you.

We are the only nation in the developed world to have this. We are also the only nation in the developed world to have statistically all wealth owned by billionaires.

But its ok. The BOOMERS have Medicare. **** everyone else.
You have my money from the mandate. **** me, that's okay.
 
Yes, that is a problem, but care like OTC pain meds and ace wraps will not break a hospital.

My question is how do people with cancer, heart conditions, strokes, etc. get healthcare?

If they have never paid into health insurance, they can simply sign up for a policy once they realize they need one. Paid for by taxes, borrowed and printed money, and the artificially high premiums of the young and healthy forced to have them.
The ACA answer was the mandate that the GOP never went along with. It forced EVERYONE to pay into the system.
 
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The ACA answer was the mandate that the GOP never went along with. It forced EVERYONE to pay into the system.
Correct.

Shifting funds from the healthy to the unhealthy, just as the architect of Obamacare said it did.

They had to use tortured language to make the mandate not be a tax, just as that architect said they did.
 
Correct.

Shifting funds from the healthy to the unhealthy, just as the architect of Obamacare said it did.

They had to use tortured language to make the mandate not be a tax, just as that architect said they did.
Correct but that is exactly the way insurance is supposed to work. Everyone shares the risk so healthcare is there if and when you need it. When you buy a house the mortgage company forces you to get insurance on it. Is that shifting funds from the good houses to the damaged houses?
 
Correct but that is exactly the way insurance is supposed to work. Everyone shares the risk so healthcare is there if and when you need it. When you buy a house the mortgage company forces you to get insurance on it. Is that shifting funds from the good houses to the damaged houses?
For your analogy comparing Obamacare to Home insurance, I would have to be allowed to buy a house, live in it for years with no insurance and then - when it catches on fire - quick buy a policy. The law would not allow the insurer to deny me because of the pre-existing condition of my house being on fire.

Yes, that would be shifting wealth from people with undamaged houses to people with damaged houses. It would be rewarding the irresponsible while punishing the responsible.

Also, if every home owner had to pay extra so that people with "low incomes" - more than 100K per year in some cases - could get homeowner insurance subsidies. Except these subsidies would not be given to these high income homeowners, but to the far higher income insurance companies.

And of course, the government would have to be printing and borrowing money as fast as it could to pay for those subsidies, since the working class is already stretched too thin to pay for all those subsidies to entrepreneurs, artists, lifelong students, etc, who buy homeowner insurance from the exchange.

Trying to make an easy-to-understand argument in favor of the ACA won't work, because as Jonathan Gruber told us, it was intended to be difficult to understand with "tortured language" to play on the "stupidity of the American voter."
 
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For your analogy comparing Obamacare to Home insurance, I would have to be allowed to buy a house, live in it for years with no insurance and then - when it catches on fire - quick buy a policy. The law would not allow the insurer to deny me because of the pre-existing condition of my house being on fire.
That is exactly wrong. Comparing Obamacare to Home insurance, you would NOT be allowed to buy a house without insurance (or pay the individual mandate, same thing).
 
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