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In my new The Week column, I express concern that failure to reform Obamacare today may push America toward a single-payer health care system tomorrow. Given that the ACA was passed in 2010, I’m not sure how many bites at the apple remain for Republicans. FreeMarketCare when? Will we at least be headed that way directionally sometime soon?
Now if you want to read two pieces on the new House GOP health care plan, definitely read my The Week piece. But as fantastic as it is, if you are only in the mood to read one thing on the topic, let me enthusiastically recommend a new column by my AEI colleague Jim Capretta. It’s chock full of real-talk goodness. Such as this:
In combination, the policies in the House bill would lead to a very large increase in the number of Americans without health insurance. It is true that all Americans could get insurance if they wanted to, but many households will see their options get worse under this plan compared to the ACA, not better. The Congressional Budget Office (CBO) is sure to make these points when its estimate of the plan is released in the coming days.
But it’s not all negative. Capretta has several ideas to fix this Obamacare fix:
First, the GOP must compromise on Medicaid. Thirty-one states expanded Medicaid under the ACA, while nineteen did not. It is possible to find a compromise that allows all states to provide safety-net insurance up to a uniform national level of income. The program could then be reformed to allow more state flexibility within a framework of fixed federal spending per enrollee. The federal government financial commitment to the program would not be cut dramatically in the near term. But, if done right, a compromise of this kind would represent a fundamental reform of the program that would lower long-term costs and improve the health outcomes for the program’s participants.
Next, the GOP should address the value of the tax credits for households just above Medicaid eligibility. It is not necessary to replicate the ACA’s credits, but it is also important to recognize that households at 200 percent of the federal poverty line (around $24,000 for a single person) will need more than $2,000 or $3,000 or even $4,000 to get a health insurance plan.
Finally, the GOP needs to aggressively pursue automatic enrollment into health insurance for persons eligible for the refundable tax credits but who fail to select insurance plans on their own. … This kind of automatic enrollment system, done correctly, could boost dramatically the number of people with insurance under both the ACA and replacement legislation.