You know if he has an idea it won't work in the real world.
Sarah Kliff at Vox has a
helpful rundown of the five-ish plans congressional Republicans have for the potential end of Obamacare subsidies in 34 states, if the Supreme Court strikes them down in a few weeks. Calling a few of them "plans" is a bit generous, since they currently only exist as vague op-eds and pronouncements. Only a few have actually been introduced as legislation.
There are three proposals coming out of the Senate, Sen. Ron Johnson's (R-WI) "Preserving Freedom and Choice in Health Care Act." He actually has introduced it as legislation and has fairly significant support, with more than 30 Republican co-sponsors including Majority Leader Mitch McConnell. Johnson's plan would extend subsidies until 2017—after what he hopes is a successful re-election—and would end the mandate in Obamacare that requires everyone to have health insurance. That means, health economists predict, that premiums would increase substantially as people who don't need insurance—the young, healthy ones—drop out. "This could," Kliff points out, "even in the transitional period, make the Obamacare markets a much more expensive place to shop."
For a review of the rest of the major plans, or vague proposals, head below the fold.
Sen. Ben Sasse, a Nebraska freshman, has also introduced legislation, the "Winding Down Obamacare Act." He has no cosponsors as of yet. Sasse has a transition period like Johnson, but it's more complex and includes a change to subsidies. He has a flat 65 percent subsidy to everyone who qualifies. Since premiums don't take into account income levels, the person making $15,000 and the person making $30,000 pay the same thing for the same policy and would get the same 65 percent subsidy. Meaning the poorer person gets screwed by Sasse's plan. He also, as the bill title suggests, winds down the subsidies, reducing them by 5 percent every month until they disappear after 18 months. He leaves the rest of the law intact, including the individual mandate. That obviously creates a huge problem, with people required by law to purchase health insurance that they can in no way afford.
The third Senate idea, which has only been vaguely outlined in an op-ed thus far, is "A Bridge Away From Obamacare," cooked up by Sens. Lamar Alexander (R-LA), Orrin Hatch (R-UT), and John Barrasso (R-WY). It suggests a continuation of subsidies for an as-of-yet undefined time period. "States on the federal marketplace would get 'the freedom and flexibility to create better, more competitive health insurance markets offering more options and different choices.'" But that's about all that we know about this plan so far, since it has only been discussed in an op-ed and that was incredibly vague.
On the House side, there are two plans that have reached the threshold of at least having been written down in some form. Tom Price (R-GA) and a handful of conservatives have introduced the "Patient Freedom Act" which largely repeals Obamacare. "The marketplace to shop for insurance, the individual mandate, the ban on preexisting conditions, the extension of benefits to young adults up to age 26—those all go out the window." It does keep subsidies, however, for people who buy insurance in the individual market which would exist presumably much like it did pre-Obamacare.
But the House proposal that would have real juice, if it's ever made into legislation, is the "Off-Ramp From Obamacare," being talked about by the House "working group" of leadership types Reps. John Kline (R-MN), Fred Upton (R-MI), and Paul Ryan (R-WI). Again, all that we really have from these guys is an op-ed and some statements to the press. From that, we know that it would allow states to decide whether to stick with Obamacare or doing something else. The individual mandate would be gone, as would the requirement that all insurance policies offer a minimum set of benefits—preventive care and maternity coverage as well as a handful of other things in Obamacare. States would decide if they wanted to keep the remainder of the requirements for insurance coverage in the law—the ban on pre-existing conditions, coverage for young adults to age 26, etc. But, every state would continue to have subsidies.
None of these is sustainable. Few would be affordable, so one of the reasons we might not have seen actual legislation from the House working group or the gang of three in the Senate is that they don't yet have favorable scores from the Congressional Budget Office. But every plan would completely destabilize the new individual insurance market as exists under Obamacare. They would all make insurance unaffordable for millions and millions of people and possibly make the situation even worse than before the law. The plans that maintain the popular parts of the law—primarily the ban on pre-existing conditions—would mean that the sickest people would be the likeliest to keep their insurance, and covering them would mean premium spikes across the individual market for everyone purchasing there, even those not doing it through the Obamacare exchanges.
Politically, they're all veto-bait, which might very well be the core of each of them. Republicans can say they're doing something, should the Supreme Court strike down the subsidies, only to have it rejected by President Obama. Once that happens, the whole mess would be Obama's fault. That is, presuming they can get their shit together enough to get enough Republicans in both the House and the Senate to agree on one plan and follow it. At this point, that seems like too high a hurdle.