For years and years, we have been promised a Republican version of Obamacare. They said it would be better. It would be cheaper. Their version would be the best thing for the country, and they would replace that nasty old Obamacare rubbish with their plan as soon as possible. All of this will be done despite the fact that Obamacare is basically a close approximation of earlier Republican plans that were formulated to keep insurers safe when Democrats were fervently seeking single payer.
So it has been close to seven years now since the ACA has passed, and still no replacement has come forth though we have had promise after broken promise of release dates for such plans. Glimmers of plans have come through here and there. Scott Walker released a semblance of a plan when he was still parading around as a candidate for President. Unfortunately, he stuck with an old solution for one problem just like most of them, and one that Ryan seems to want to warm over too.
Now finally, Paul Ryan again is teasing America with hints that the Republicans have come up with a plan to be released at the Republican National Convention. He gave a speech to students in Georgetown touting one or two of the provisions he saw as great things for his new plan that would make it appealing to the young people gathered there listening to him. However, I think maybe he had people used to the constant conservative echo chamber or who didn’t quite know what he was proposing yet.
After all, speaking to college students, you have the advantage of talking to people who have never had to buy their own insurance, and often people who have never lived without it. Most of us know, though, that one of the most popular features of Obamacare is that insurance companies can no longer discriminate against people with pre-existing conditions like diabetes, asthma, or even cancer. Paul Ryan’s new plan wants to go right back to an old way that we know didn’t work and certainly won’t now – high-risk pools.
Essentially, we ostracize these sicker people from the healthy, into groups that have to pay higher rates that he wants subsidized by the federal government. This has been done before at state levels, and it has failed many times before. Insurance companies don’t generally want to touch it, and governments don’t want to fund it. Think about how stingy our lawmakers are now funding social safety net programs. Do you really believe they wouldn’t cut this coverage at the drop of a hat if they thought they needed the money elsewhere, like another tax break for the wealthy or a new warplane?
Another issue brought up was insurance underwriting, which companies currently can’t do in the ACA. All that basically means is that insurers can charge more based on your previous medical history. Let’s say you went to the hospital a lot as a child because you were being abused, and you just left home to go to college or whatever. The insurance company looks over all of that and assumes you are accident prone. You pay a lot more in premiums because of your history than the average person your age because they believe you are a much higher risk.
Women pay a higher rate with underwriting because they have children. Young men also pay higher rates because they are believed to be more violent than older men. Underwriting is a blatant system of discrimination, and that is why it is not used in the ACA. I am not saying that underwriting doesn’t have its good points, but it has often been used to excess to tack on fees and costs to make a company money.
Much of what has already been talked about by Paul Ryan is essentially a throwback to the past. Sure, if you are young and healthy, by making these changes your prices go down. After all, when you eliminate most of the risk for the insurance companies, they are making money by insuring the healthy. However, the point of making the changes we did in the first place was a statement to society that we didn’t want to leave those most in need behind to suffer anymore. By going back to the old way, aren’t we doing that again?
These people will be charged insane prices again which means many of them won’t be able to afford their insurance, especially with the current wage stagnation. This will cause a lot of people to suddenly not want to pay for insurance, and a sharp rise in uninsured. Unless of course we keep the new stricture that everyone must have insurance. Republicans may justify this part by saying that if everyone has insurance, it will drive down the cost. It will, except for those you have put in the high-risk pools and those who suffer from the bias of the underwriting you have reinstated.