Politico has obtained a draft bill from House Republicans for Obamacare repeal. The draft closely follows proposals put forward by House Speaker Paul Ryan and the proposal Tom Price introduced last year. He's now popular vote loser Donald Trump's Secretary of Health and Human Services. The outstanding features of the proposal do one thing: fuck the GOP's base by scrapping Medicaid expansion and by allowing insurance companies to charge older people much more for insurance.
The Republican plan would also eliminate Obamacare’s Medicaid expansion in 2020. States could still cover those people if they chose but they'd get a lot less federal money to do so. And instead of the current open-ended federal entitlement, states would get capped payments to states based on the number of Medicaid enrollees.
Capped payments is basically the same idea as a block grant. The state would get a set amount of money—less than currently under Obamacare's Medicaid expansion—depending on the current Medicaid population size. If for some reason the Medicaid-eligible population increased in a state, it would have to do that thing Republicans falsely screamed bloody murder about with Obamacare: ration care. It would have to decide whether to keep covering children, or the disabled, or the elderly in long-term care. Which means, fewer people covered.
So that takes care of fucking over the white working class. What are they doing to older people?
Other changes proposed by Republicans align with previous ideas for strengthening the individual insurance market, which has been unstable under Obamacare with rising premiums and dwindling competition. For example, the legislation would allow insurers to charge older customers up to five times as much as their younger counterparts. Currently, they can only charge them three times as much in premiums. The insurers have been pushing for that change.
Five times. Based on the proposal put forward previously by Ryan, Price, and others, three health policy and economics experts have determined that everyone Obamacare enrollees premiums are going to spike, but that they'll hit older people particularly hard.
We estimate that the Republican approach would increase the average total cost for an individual covered by the Affordable Care Act by $1,744 per year. The impact would be particularly severe for individuals ages 55 to 64, whose total costs would increase by $6,089 annually. [emphasis added]
Republican town meetings are going to start getting really interesting now.