The Republican “Obamacare Do-Over” – But Is It Enough?

Ed_GillespieEd Gillespie, the Republican senatorial candidate in Virginia, did not win his election. But he did come close in the purple state, receiving more than a million votes. Central to his platform was a 5-point plan for economic growth, and the first point was his proposal to replace Obamacare. The plan was developed by the 2017 Project, a public policy group.

In his recent op-ed in the New York Times, Gillespie wrote:

We need to get rid of Obamacare instead of attempting to fix it because it is fundamentally flawed, cleverly designed to lead us over time to a single-payer system. This will become clearer when the employer mandate provisions kick in next year, with their incentives for companies to dump workers from their employer plans into government-run exchanges. As the exchanges swell and become more costly to taxpayers, we’ll be told that a government monopoly would be more cost-effective.

To push back against the bill’s gravitational pull toward a single-payer system that would essentially supplant private insurance with a government program, Republicans must have a plan that addresses the concerns that led to Obamacare’s enactment in the first place: rising costs, too many uninsured people and a lack of protection for patients with pre-existing conditions.

Gillespie’s plan begins by fixing the tax code, which currently gives a tax break to people who get health insurance through their employers, but does not to individuals who purchase outside of the workplace. The plan would offer health insurance tax credits to individuals and families who buy insurance on their own. These would benefit all Americans, unlike the Obamacare premium assistance which only benefits lower income and elderly participants. Adult children up to age 26 could still retain coverage.

While preserving the tax break for employer-based insurance, my plan would offer health-insurance tax credits for all individuals and families who buy insurance on their own. The tax credit would be $1,200 per year for those under 35 years of age, $2,100 for those 35 to 49, and $3,000 for those 50 or older, plus $900 per child. For a family of four headed by two 40-year-old parents, the tax credit would be like having $6,000 in cash to spend on health insurance. If the family found a plan they liked for less, they could put the difference in a health savings account to help cover out-of-pocket expenses.

People with pre-existing conditions would be protected. $7.5 billion a year would be allocated for state-run “high risk” pools to serve people who don’t qualify or cannot afford insurance in the open market. Americans would be free to shop for value by comparing prices. The plan supports sensible medical and malpractice reforms, and caps the break on employer-based insurance at $20,000 per family plan.

Medicaid would go back to the eligibility levels that precede Obamacare. People who were added to Medicaid under Obamacare could buy personal insurance with their new tax credits.

Gillespie says of his proposed reforms “would lower premiums, increase consumer choice and not disrupt doctor-patient relationships.” He adds, “Obviously, enacting legislation along these lines will require a Republican president.”

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