The GOP's supposed "replacement" for the Affordable Care Act (ACA) is an absurd joke.
The "Republican Study Group" (a group of the congressional conservative caucus) hypes their hollow, fake bill on its website with predictably empty language, like "patient-centered reforms rooted in free markets".
The proposals are the same inconsequential ideas they've put forward before when pressed for answers; provide increased tax advantages to people who use health savings accounts, dramatically limit the rights of patients to sue for damages in cases of medical negligence or incompetence, eliminate restrictions on selling health insurance across state lines (the ACA already allows this), etc.
At best, these proposals do practically nothing to impact the serious problems that our broken health care system poses to individuals and to the nation as a whole. At worst, it exacerbates some of the current system's worst features. For instance, the fractured nature of the US health care system is one of its greatest weaknesses and one of the major drivers of our high cost. The GOP "solution" makes this bad situation worse.
But perhaps the cruelest part of this GOP joke is how it supposedly answers what is arguably the Affordable Care Act's most popular feature -- which is to end the practice of allowing insurance providers to deny coverage for pre-existing health conditions. Roughly 10 million people in the US are classified as "uninsurable". Those of us who aren't are only one mishap away from finding ourselves on the outside looking in. People everywhere overwhelmingly agree that this practice is intolerable.
The GOP brags how their plan solves this problem. From the website:
"Safeguards individuals with pre-existing conditions from being discriminated against purchasing health insurance by bolstering state-based high risk pools and extending HIPAA guaranteed availability protections."
But, look at their actual proposed legislation (H.R. 3121), and here's what you'll find:
<<Subtitle B—Ensuring Coverage for Individuals With Preexisting Conditions and Multiple Health Care Needs Through High Risk Pools
SEC. 311. IMPROVEMENT OF HIGH RISK POOLS.
Section 2745 of the Public Health Service Act (42 U.S.C. 300gg–45) is amended—
(1) in subsection (a), by adding at the end the following: ‘‘The Secretary shall provide from the funds appropriated under subsection (d)(3)(A) a grant of up to $5,000,000 to each State that has not created a qualified high risk pool as of September 1, 2013, for the State’s costs of creation and initial operation of such a pool.’’;
(2) in paragraphs (1) and (2) of subsection (b), by striking ‘‘and (2)(A)’’ and inserting ‘‘(2)(A),(3)(B), and (4)’’ each place it appears;
(3) in subsection (b)(3), by inserting ‘‘with respect to funds made available for fiscal years before fiscal year 2014,’’after ‘‘applicable standard risks,’’;
(4) by adding at the end of subsection (b) the following new paragraph;>>
The rest of the section is a page and a half of language to make sure that no funds are used for non-US citizens. That's it. That's the entire extent of their "Safeguards" for "individuals with pre-existing conditions from being discriminated against".
This is not a serious plan. It's a joke. They want people to believe that they have a serious solution to address the 45 million Americans who are uninsured, the10 million people who are "uninsurable", the fractured health care system that makes our health care system by far the most expensive in the world, and most importantly, the unquestionably unsustainable long term fiscal outlook for our health care system if these problems are not addressed.
http://rsc.scalise.house.gov/solutions/rsc-betterway.htm
http://rsc.scalise.house.gov/uploadedfiles/bill_american_health_care_reform_act.pdf
What's really pernicious is that they've created this illusion to give the false impression that they have a credible alternative. They don't. This is a sham. The ACA isn't a perfect solution by far, but it's a credible and serious attempt to answer the problem at the appropriate scale.
The long term fiscal sustainability of Medicare and Medicaid is what's at risk. This is a serious problem that requires a serious solution. By most every account, the ACA will improve the long term prospects for Medicare. It will result in a healthier population entering Medicare upon retirement age. That's the problem. Millions of unhealthy, uninsured people entering Medicare with 40 years of untreated, chronic, illness is unsustainable. This isn't a guess, it's a fact. The demographics and economics are are unquestionable. We must act and act now. The GOP answer of adding a few commas here, and subtracting a few commas there from existing law is delusional and irresponsible.
