Trumpcare Is Like Obamacare, but Even Worse

The GOP health plan tacitly accepts Obamacare's central premise: that governments should micromanage insurance markets.


From the way Democrats are talking about Republican reforms to Obamacare, you'd think the Party of Lincoln was going house to house murdering people:

Hillary Clinton tweeted that "[i]f Republicans pass this bill, they're the death party."

Elizabeth Warren called the Republican health care bill '"blood money" that's being used to pay "for tax cuts with American lives."

In reality, the GOP isn't even coming close to following through on its promise to repeal and replace Obamacare. If it did, it might actually save lives, increase quality, and bring prices down.

The plans put forth by House and Senate Republicans, which are supported by President Donald Trump, keep in place the worst elements of the Affordable Care Act.

The House bill, for instance, replaces Obamacare subsidies with refundable tax credits, meaning the government would still pay people to buy insurance. Though it wouldn't require people to get insured, it does impose a penalty for dropping coverage that amounts to the same thing.

The Senate bill, in the words of Reason's Peter Suderman, is "just Obamacare, but less of it." Like the House bill, it requires that insurers accept all applicants regardless of pre-existing conditions and limits their ability to charge more for sicker patients. And it authorizes payments to insurers to cover losses imposed by price controls.

The real problem with both bills is that neither challenge Obamacare's central premise, which is that the federal government should micro-manage medical insurance markets.

Neither bill would increase the supply of health care by relaxing licensing requirements or getting rid of state laws that allow existing hospitals to bar new entrants into the market. These rules are one reason health care facilities tend to stay open no matter how poorly they serve their patients.

Neither bill would change the tax codes that encourage us to buy insurance for even routine health care costs, meaning patients don't even see the bills for routine procedures throat cultures and blood tests. Until providers are forced to compete on cost, the market forces that bring down prices and raise quality in every other sector will remain stillborn.

The GOP controls both houses of Congress and the White House. These bills don't just fail to repeal and replace Obamacare with real reform, they would extend its life for years to come. They represent not just a failure of nerve, but a failure of vision that would actually help deliver 21st century health care for us all.

Edited by Todd Krainin. Written by Nick Gillespie. Cameras by Jim Epstein and Kevin Alexander.

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  1. Can we please stop calling it ‘Obamacare’ or ‘Trumpcare’? I never really liked the moniker Obamacare, because it was an effort to attach the popularity of the program to the popularity of the President instead of to the merits of the program.

    Likewise, calling this ‘Trumpcare’ is an effort at attaching the likability of the program to the likability of the President only in the opposite direction.

    I’m starting to think that all of these damn programs should simply be called ‘CongressCare’ if we’re trying to conflate the popularity of things, because ultimately no matter what happens your healthcare will be decided by Congress instead of by you.

    While it’s more-of-the-same in attaching likability of the program to a particular person or group, at least it would be a more accurate conflation.

    1. I, for one, refer to the ACA as “Democratcare”.

      1. I usually say “Affordable Care Act,” and then feel obliged to remind my audience that the first two words are lies.

        1. When did we drop the PP? I thought I was in good company by calling it PPACA, then one day it seemed like people were only calling it ACA.

          1. I usually just forget. Including the “Patient Protection” in my formulation would double the number of lies.

            1. I’m making over $7k a month working part time. I kept hearing other people tell me how much money they can make online so I decided to look into it. Well, it was all true and has totally changed my life.

              This is what I do…

            2. I’m making over $7k a month working part time. I kept hearing other people tell me how much money they can make online so I decided to look into it. Well, it was all true and has totally changed my life.

              This is what I do…

    2. Wasn’t it Republicans who started calling it Obamacare….? IIRC, they were trying to tie it around his neck and let it sink him – exactly what Democrats are doing now. I agree that the weird smear campaigns are not helpful, but I’m pretty sure that’s what they are: attempts to muddy the waters and conflate a president’s personal popularity with the legislation.

    3. Can we please stop calling it ‘Obamacare’ or ‘Trumpcare’?

      I kinda dislike the notion of rather arbitrarily declaring one to be worse than the other. It, especially from a libertarian perspective, is like saying the deck chairs being organized on the Titanic is worse because it means Team Stupid, who promised to stop the ship from sinking, is worrying about the deck chairs.

      Not to get all Ken Schultz-y, but the ship is going down and Rand Paul jumped into a phone booth and emerged in blue tights and red underwear, he wouldn’t be able to save it. Whether we pay the sum in penaltax or as a portion of income tax or through depressed salaries and employer mandates is relatively moot. At least with the mandate repealed and the deck chairs organized, the downward plunge can be relaxing and orderly.

      1. Collectivists name shit after Fearless Fuehrers. It’s what they do…

  2. Awesome picture.

    1. I wonder how much they paid Crusty for the use of his likeness.

      1. A ride in a car and a slightly used Jolly Rancher, probably.

      2. Crusty doesn’t wear gloves for that particular procedure.

        1. He wears ONE glove. Guess where.

          1. Do you know who else wore one glove?

              1. Wrong answer but better than the correct one. You get extra credit for showing initiative.

  3. Okay, that picture gave me a raging case of TDS. Thanks Reason.

  4. Can’t we just call them Cubacare1.0 and Cubacare1.1?

    1. More like Bismarckcare 1.1 and Bismarckcare 1.2.

      1. No, not Bismarckcare: Germans are paranoid about balancing their budget, and in the German system, the rich don’t pay for the poor.

  5. Once government seizes a power it does not readily relinquish it, regardless of which party is in power. That is why the real disaster in the original act was the haste with which it was enacted and the fact that most in Congress had not read the finished version. Now we are stuck with it, as will be our children and grandchildren.

    If the GOP really wanted to “repeal and replace” they had six years to figure it out. Either the party is really comprised of the stupidest legislators ever known to man, or they never intended to “repeal and replace” in the first place. Which is it? Two guesses, and the first two don’t count.

    1. They relinquished the income tax of 1894, and the christian coathanger abortion laws that existed before the LP got that single electoral vote. They quit murdering women and kids in ‘Nam. They let go of those forking Blue Laws, and laws against baseball on Sundays. Several states recently quit shooting kids over plants. All you have to do is vote to take away their tax-funded government jobs/guns and the looters will slit each others’ throats to repeal whatever it was that got people to actually VOTE for freedom (as opposed to some drooling looter).

    2. The GOP was caught off guard by Trump’s election. They figured Hillary would win and they could go on bashing Obamacare running on “repeal and replace”.

      1. This is absolutely true.
        This, combined with their never expectation that they would have control of all three branches of govt.
        Now that they actually have to commit to what they said they would do, something they thought would always be theoretical, they are having actual commitment issues, like it is too much for them to wrap their minds around.
        This was a major reason they were elected, a loud campaigning point, something people want dismantled, and yet they hem and haw, and just can’t seem to pull off the money shot they all promised us.
        Maybe libertarian will be more palatable for the voters next time.

  6. Folks, even the most cursory research shows immediately that Trump is and always has been fully in favor of so-called “universal” or “single-payer” healthcare. These psychopathic fools have no intention of ever undoing Obamacare ? only making it worse.
    I’m sorry, but if you were dumb enough to think that Trump or the congress would ever, ever, ever unwind the biggest racketeering matrix in human history, you deserve what you get. Keep writin’ those quarterly tax checks! I’m sure if the Republicans can just pick up a few more seats? OH. WAIT.

  7. The problem isn’t the problem, and the Republicans are doing their best to double down on the derp. The issue has always been making health care more affordable and the dissention was on how to accomplish this goal. The best I can figure is the Republicans are willing to dismantle the ACA without doing anything to address the problem of cost. I see this as causing them real issues in the next couple election cycles. The Democratic base will get whipped up over the issue, and middle America is going to realize they are still getting screwed.

    I don’t think there is any realistic way to cut social programs out of the equation. Maybe the government could sponsor concierge type clinics for Medicare and Medicaid. They would staff this with doctors that get college loans from the govt, but they owe a number of payback years in order to have loan forgiveness. I know this isn’t very libertarianish of me, but at this point I would just like to see a reasoned approach to solving the mess that’s been made.

  8. Since “both (looter) parties” demand more socialized medicine than Hitler put in the NSDAP platform, why not compare what these jerks are pushing with Canada’s system?

  9. “Trumpcare Is Like Obamacare, but Even Worse”

    Followed by an article complaining how the congressional proposals only improve on obamacare in minor ways.

    It’s like fake news BUT EVEN WORSE!

    1. What is worse is that it cements in place the idea that govt should control healthcare. F them all (except Rand and co)

      1. That really doesn’t make sense to me. I’ve always felt that if a point needs fancy metaphorical language to be supported, then one should consider perhaps that there really isn’t a basis for it.

        Suppose republicans repealed obamacare then passed obamacare again. Their bill, despite being identical to obamacare, would be worse than obamacare? Ok that sounds silly however.

        1. The only way they can actually repeal Obamacare is if they nuke the 60-vote rule in the Senate so they can pass legislation without a majority vote only. I don’t think this will happen, so we’re stuck with the half-ass measures allowed by “reconciliation”.

  10. Then would you support Sen. Cruz’ amendment to allow insurance companies to offer non-compliant plans in a national market-place if they offer a plan that complies with the mandatory coverage called for in BarryCare, allowing consumers to choose their “poison”?

    1. All I want is catastrophic plan that is available nationwide. Why can’t I just buy that?

      1. RIght-o. I’ve been telling people for years: insurance is NOT CARE. It’s a hedge against disaster. You finance a home, you gotta have insurance, but you don’t file a claim if you need to wash its windows, clean its gutters, or re-stucco its surface. You pay for that out of pocket, budgeted because, you know, LIFE COSTS MONEY. If a hailstorm knockout out your skylights, okay, you have an insurance claim.

        So the only insurance we really need is catastrophic.

        Which brings me to costs: why is it possible for the vast majority of us to budget for our shelter, groceries, and utilities (without which we’ll die a lot sooner than if we don’t have HC insurance) without help from the government, but for some reason we can’t seem to put aside money for basic medical expenses? I wager it costs more to grow, harvest, and bring food to market and to build homes than it does to provide basic medicine. It’s not freaking rocket science, actually. Hell, most doctors will admit their jobs are based mostly on anecdotal evidence. Hit and miss. Art as much as science.

        Health care costs so much because government meddling has driven up prices.

        Get gov’t out entirely, cut the umbilical cord between ins. companies and Congress, and you can bet the demands of consumers will bring prices down, and you’ll see insurance companies offering catastrophic plans again.

        1. OMG, that is exactly what I have been saying too forever.
          A health management plan, is NOT health care insurance.
          A home management plan, is not homeowner’s insurance.
          A car maintenance plan, is not car insurance.

          If all we want is catastrophic health insurance, why are they pushing on us an entire life servicing plan that controls and charges for anything/everything health care related.
          Term life insurance vs Whole Life insurance.

          They want to be your constantly involved institution – partners in life, instead of the rare emergency medical team only when you need it.

  11. Very much reminds me of the faux outrage democrats had over the Patriot Act only to renew it as is when they controlled all 3 branches of government. Now republican establishment faux outrage is exposed as well.

    We do have a one party system that has no respect for individual freedom nor constitutional rights.

  12. Smile! You know you’re going to like it!

  13. Yes, as a matter of fact the government SHOULD regulate insurance markets, the degree to which is open to discussion. People and businesses are fundamentally greedy. Ferengi Rule #10: “Greed is eternal.” At least with government regulation the citizens have a flawed and imperfect lever to manage the greed and see some of it.

  14. Poor Nick, I don’t think he even believes what he just wrote. If the government does not force me to buy a plan I don’t want, we are stepping in the right direction. The current ACA is unconstitutional no matter what piss boy John Roberts and the Dem Hacks on the Supreme Court thinks. The politicians will buy votes until everything crashes and then try to shift blame somewhere else.

  15. Say, macho libertarian guys (a decent woman wouldn’t be caught dead posting here), why don’t you pack it in and return to your caves. The world has passed US by as we still go around with our clubs (AK-47’s) to show off our manhood. As for healthcare, we have the worst, most fragmented, highest cost, poorest results of any advanced and intelligent nation. Single payer, no questions asked, is the way of the future. The problem is that the vast majority have been brainwashed into believing that our healthcare system is the world’s best and must never be changed.

  16. RE: Trumpcare Is Like Obamacare, but Even Worse
    The GOP health plan tacitly accepts Obamacare’s central premise: that governments should micromanage insurance markets.

    I couldn’t have said it better.
    Now its the republicans turn to fuck up health care here in America.
    Won’t life be wonderful?

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