By Max Friedman
With the 2016 Presidential race heating up, two leading GOP candidates have now released plans for what they claim will fix our broken health care system.
We wrote before that health care barely came up in the first Republican debate. However, in the two weeks since, both Governor Scott Walker and Senator Marco Rubio have outlined their vision for health care if they rise from candidate to president.
Governor Scott Walker of Wisconsin released his “Day One Patient Freedom Plan” on Tuesday with a speech laying out the details. Walker would repeal the Affordable Care Act (ACA) and replace it with a system of tax credits to individuals to purchase their own coverage. Walker bases the tax credits on age, rather than the ACA’s income-based subsidies.
A person aged 18-34 would receive a $1,200 credit to buy coverage, while someone aged 50-64 would get $3,000. By comparison, a Vox article on Walker’s plan shows that under the ACA, a 25-year-old earning $17,000 would receive a $1,962 subsidy.
Walker’s plan erodes the ACA’s prohibition of health insurers not covering preexisting conditions, requiring people to have continuous coverage to ensure that they are fully protected. A study found that between 2004 and 2007, 89 million Americans had at least a one-month gap in insurance coverage.
Walker would also gut other regulations in the ACA, such as scrapping the Essential Health Benefits (mandatory benefits included in health care plans offered to the general public) and would enable health insurance plans to be sold across state lines, which would weaken efforts by states like Connecticut to require coverage of certain medical conditions and procedures.
Senator Marco Rubio of Florida also released his plan for health care on Tuesday. Writing in Politico Magazine, Rubio offers many of the same policies, including moving Medicaid to a block-grant system to the states based on population rather than income levels and transitioning Medicare from its current structure to a premium support system, in which seniors would be provided a voucher to purchase their own private coverage. He would also wind down tax preferences for employer-based coverage, which would affect millions of Americans who receive insurance through work.
What It Means
According to the nonpartisan Congressional Budget Office, repealing the ACA would result in 19 million people losing their health insurance coverage in 2016. Rubio and Walker’s proposed tax credits would not be enough for many Americans to purchase decent coverage. Block granting Medicaid would mean that the program would be subject to Congressional appropriations, with increases based upon general inflation, not rising costs in health care. This will put further strains on state Medicaid programs, which may lead to fewer health care providers accepting Medicaid patients.
Many of the ways these Republican candidates propose to ensure affordable, accessible care are just more convoluted methods which have been tried before, or recreate key portions of the ACA. Ezra Klein notes in Vox that many Republican complaints about the ACA would be made even worse by the policies which they espouse.
We will continue to monitor what the candidates say about health care in the coming months, including the Democratic candidates, none of whom have a dedicated section on health care on their campaign websites. The next Republican debate is on September 16, and the first Democratic debate is on October 13.