Trumpcare Is Like Obamacare, but Even Worse

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


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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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