why you should oppose the Republican health care bill (aka the ACA “repeal and replace”)

If you want to read the bill itself, you can do so at the clever URL ReadTheBill.gop. I tried to get through it and gave up – it’s 120 pages and not the easiest thing to read. But I do appreciate having the bill easily available!

If you want to read articles by people smarter than me, here’s a pretty good summary, and here’s an article wondering why the bill exists because both conservative and moderate Republicans are unhappy about it for different reasons. And here’s a roundup of how people are responding to it.

Here are some weird/bad things about it:

If you don’t have insurance through your employer, poorer people will get less of a subsidy/tax credit, and richer people will get more – see here for a chart with some samples. The original bill would give a tax credit to everyone (without employer health insurance) based solely on age, so Mark Zuckerberg and I would get the same amount. Now they added some phasing out based on income, so Zuckerberg won’t get anything. But it’s still less progressive than the ACA, and people are worried that more low-income people won’t be able to afford insurance at all.

We don’t know how much it will cost or how many people will lose coverage because the Republicans are voting on it out of committee tomorrow – the plan was released yesterday and they want to vote on it tomorrow! They’re not waiting for the Congressional Budget Office to “score” it, which is awfully suspicious. An expert suspects 15 to 20 million people would lose coverage under the bill.

The individual mandate is gone, but if you stop coverage and later want it your premiums will go up 30% which is just weird. One big problem you have to worry about in healthcare is that people will not buy insurance until they get sick, then they’ll buy it to cover procedures, etc. This can lead to the feared “death spiral” where more healthy people drop their insurance, which makes premiums go up, which makes more healthy people drop their insurance, etc. Pre-ACA insurers dealt with this by either refusing to cover people with “preexisting conditions” or raising their premiums sky-high. The ACA attempted to solve this with the mandate, which says you have to have insurance or pay a penalty. But raising someone’s premium by 30% is probably not enough to dissuade people from doing this.

There’s a sweet tax break for insurance company executives that make more than $500K because it wouldn’t be a Republican bill without a tax break for the rich, I guess?

Six pages of the bill deal with keeping lottery winners off of Medicaid which really threw me for a loop when I started reading the bill! (more coverage here)

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