Surely, one of the first things to go under President-elect Donald Trump will be the Affordable Care Act, more commonly known as Obamacare. But what this health care legislation will be replaced with, if it is replaced at all, is up in the air.
Trump has vowed to repeal Obamacare, but remains ambivalent as to what is going to come after this event. In an interview with 60 Minutes, Trump floated the idea that two principles of Obamacare — allowing for children to stay on their parent’s plans until the age of 26 and keeping the provision that forbids health insurance providers from denying coverage to people with preexisting conditions — would be kept.
Other than that, Trump’s vision for health care in the United States is certainly lacking and this lack of vision is especially concerning when Vice President-elect Mike Pence stated that repealing Obamacare would be Trump’s “top priority.”
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The only thing clear is that Trump will work with Congress and the states to implement some form of legislation in the field of health care. Wisconsin native and Speaker of the House Paul Ryan, R-Janesville, created the official Republican Congressional plan.
It isn’t hard to imagine that Ryancare will end up replacing Obamacare. If this proposal is to be adopted, there would not be significant changes to the framework of Obamacare.
First and foremost, this plan embraces the idea that every American should have access to health care, with the proposal’s guiding principle stating, “In a confident America, everyone has access to quality, affordable health care.”
Ryancare is based on granting individuals tax credits in order to pay for health insurance for those who do not qualify for Medicare or Medicaid or do not have an employer-provided health care coverage, a provision that already exists under Obamacare. But Ryancare doesn’t have the specific size of the subsidy laid out in his 37 page proposal. Currently, those making less than 400 percent of the federal poverty line automatically qualify for subsidies from the federal government to buy health insurance.
Many other provisions of Ryancare are Obamacare-esque. Ryan’s plan vows to keep the provision that forbids health care providers to deny coverage to people simply because they have a preexisting condition and children under the age of 26 can stay on their parent’s plan.
The main difference resides in how people come to access their insurance. Ryancare emphasizes the principle that increased competition in markets can effectively lower costs, while Obamacare is more of a public-private bond to lower health care costs.
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One thing is for sure, Obamacare utterly failed to hold steady or even lower health care costs, as was predicted. The thought process was that insurance companies would lower their prices to fight for millions of new Americans, who were mandated to buy health care coverage, to come to their plans. Thus, Obamacare would increase competition among insurers, leading to lower prices for consumers. But a study by S&P Global Institute found that between 2013 and 2015, average individual market medical costs rose by an estimated 69 percent.
Not only did Obamacare fail to lower costs, but it has failed to increase competition. In 2017, seven states will only offer one insurance plan to their citizens through the Obamacare marketplace, Avalere, a Washington, D.C.-based health consulting firm experts, predicts. This, effectively, gives these insurers a monopoly on the states.
Ryancare, on the other hand, includes provisions that should solve this problem regarding lack of competition.
First, there is a provision that allows for people to buy health insurance across state lines, eliminating the seven states where there is a monopoly on the Obamacare marketplace and increasing competition overall.
Second, small businesses are allowed to pool together to negotiate health care prices with insurance providers. The goal of this provision is to give small businesses a stronger voice to reign in health care costs.
But, of course, there is one big factor that can mitigate any positive changes these increases to competition provide — a repeal of the mandate to get health insurance.
The reason for mandating all people to get health insurance is to have younger, healthier individuals pay for the health coverage of older Americans, seeing as young adults cost health insurance companies much less to insure than elderly Americans. Removing the mandate for health insurance will lead to young people leaving their insurance plans, based on the fact that health insurance costs far outweigh the benefits for them.
Just like Obamacare, Ryancare provides a mix of positives and negatives into the health care landscape, leaving Americans with a lot left to be desired.
Aaron Reilly ([email protected]) is a sophomore majoring in social work and economics.
