Finally after a six-year gestation period, Paul Ryan and the House Republicans have finally given birth to their answer to the Affordable Care Act (ACA). After going through the Bill we kept hearing Peggy Lee singing “Is that all there is?” The Bill has been derided by the Democrats as “Obama care Lite”, but it’s more Dave’s Plan Lite-very lite. The whole idea of any healthcare plan is to provide decent care at a reasonable price. The ACA’s rapidly increasing premiums and deductibles, disappearance of policy choices in wide swaths of the country and the diminishing number of providers taking Medicaid are well documented. Just how the Republican Bill does much to fix these problems escape us.
The main cost suppressants in the bill are the ability to buy basically catastrophic policies across state lines and expansion of Health Savings Accounts (HSA). Dave’s plan has always had this across state line provision. In fact we feel you should be able to buy coverage from any financially stable provider at home or abroad. Insurance , drugs or surgery, get the best deal you can nationally or internationally.The more competition the better. The problem is it doesn’t fully address the real insurance killers, pre-exiting conditions and failure to maintain coverage. It provides a “Patient and State Stability Fund” to subsidize states dealing with high risk patients but unlike Dave’s Plan, falls far short of covering all pre-existing conditions and ultimately eliminating the problem. For instance, people exceeding Medicaid income limits or have an employment change in the future may have become a high risk making the pools and costs are endless. The Republican Plan maintains the ACA’s prohibition of the pre-existing condition exclusion, but allows for up to a 30% penalty for lapsed coverage. As we have said before, when you force insurers insure sinking ships it just isn’t real insurance. Just a government & crony capitalist hook-up. With no mandate force the purchase of insurance and this as the only deterrent it is unlikely to lower premiums. You can avoid paying for 5 or 10 years and then pay only a 30% penalty for your knee replacement. This gives young and healthy even more incentive to stay out than under the ACA. Under Dave’s plan policies initially cover reasonably healthy people. Those that can been handled within their Personal Benefits Account (PBA). The rest go to subsidized high risk pools. Because the policies are universal, individually owned, no lifetime limits and non-cancelable, the pre-existing condition problem in time will cease to exist as they either go on medicare ore or sadly pass away.. As the PBA pays the premiums, there can be no lapse problem. People just don’t realize how expensive it is to insurers to sell a policy and put it on the books only to have it lapse shortly thereafter. In the insurance business these costs often equal or exceed the first year premium. As policies are purchased annually this loss doesn’t exist under Dave’s plan. Because of these differences, one can readily see policies under Dave’s plan would be much cheaper.