Since the Ocare replacement was only about 130 pages, I actually downloaded it when it was first put up. First, the bulk of what I read had to do with Medicaid expansion, and freezing it then killing it over time. Then Planned Parenthood, but as I read on, it became clear that TO ME, the beating heart of what could make premiums cheaper, and increase available health care for all, the ability to buy any plan in any state, without some kind of canard like a limited set of doctors 10 miles of Pierce, Idaho, WAS NOT THERE.
We had to wait for a phase 2 or phase 3.
This struck me as trying to make peace in the Middle East by leaving status of Jerusalem and Right of Return for these two phases. We’ve actually seen such a process in operation in Oslo, and at Wye in 2000. We know the results.
We all also know that the only way Ocare was able to dictate a market was to guarantee the insurance companies a mandated incremental market size, and LEGALIZE the underwriting of proof of profit (bailout any losses). ‘We give you insurance companies 23 million new customers (12 million paying), and we guarantee you no losses in order to have you provide insurance’
Within 2 years here in Maine we had ONE insurer despite these guarantees, and one invented non profit, and the non profit went out of business. The bailout guarantee was removed and now Anthem lost $80m and wants out. I have no idea how many states, counties or parts of counties (which is how Anthem divided up this state) are in similar conditions.
Some of you may remember the mass of confusion when I tried to sign up for Ocare and found that the individual policy I could get thru my wife’s Anthem group was $978 for one, me. Since this was available, though unaffordable, there were no subsidies possible, and Ocare was $1378 for a much worse policy, AND the reason was that even though coverage could not be denied, the basic premium goes up as you get older until it is TRIPLED ( IOW – penalty for previous conditions as a theory of actuarial design).
Was the Ryan plan going to be better? WHO COULD KNOW? All I saw was tax credits to pick what was available in your state, and of course the choice was now MOOT. What happens to premium when there is a monopoly? DUH.
My conclusion was that it would take a GIANT LEAP of trust in PAUL RYAN and house leadership to vote yes. I don’t have that trust.
I don’t trust what Phase 2 and 3 MIGHT BE NEGOTIATED into being as the structure of the entire insurance industry (which underwrites 1/6 of the economy) came to bear on individual congressmen as they took the HUGE step of national insurance availability.
This was a strategically poor design, with so-so to decent tactics on the floor which NEVER had a chance because of it’s poor design and theory. That’s all on Mr. Ryan, frankly and those who helped him design as simpler kluge than Ocare.
We all know that Ryan is a free market ideologue (supposedly) and look at what he created. He wants open borders, he wants free trade, yet he created THIS?
I am glad this is dead, and I am not glad this is dead, but this fiasco is his.
You have to wonder if this is the political class simply in an inchoate manner to kill repeal and replace, and therefore kill a big enough tax cut to get to 4%+ growth and. hey, presidents come and president s go, and congress and its interests will be here in 2021 and Trump won’t be.