The Senate released its latest attempt to tweak Obamacare this morning. It is 172 pages. Compared to the last Senate version, it is a mishmash of poor and decent policy mixed in with a few 'Cornhusker Kickback' styled giveaways designed to lure in some straggler Republicans. You can view a side-by-side comparison of the two bills here.
It could forestall America's slide to single-payer healthcare for a couple of more years and prolong our partially-socialized hybrid provided politicians could stick to the reduced growth in Medicaid. But, like the supposed 'Doc Fix' legislation that limped along for more than a decade, I strongly suspect politicians will fold years into the future when the politics of shrinking a government handout becomes difficult to sell to clamoring constituents. Few politicians are actually known for their robust spinefullness.
As Senator Rand Paul has accurately put it, "too many Republicans are falling all over themselves to stuff hundreds of billions of taxpayers’ dollars into a bill that doesn’t repeal Obamacare and feeds Big Insurance a huge bailout."
Here are the changes to the Senate bill to appease the GOP's more liberal majority:
- $45 billion more in federal giveaways to help treat the opioid addiction problem in America;
- An extension and reaffirmation of three more Obamacare taxes. Recall that all earlier versions of this legislation kept the 'Cadillac Tax.' Now under pressure from the left, the GOP has fully reneged on its pledge to repeal every ACA tax by adding three more politically sellable ones back in -
- the 3.8% tax on investment income for individuals making more than $200,000 per year ($250K for couples). While taxing the rich is a great political rally cry, it costs business investment, private sector jobs and makes people poorer overall;
- a .9% surtax on Medicaid for individuals making more than $200,000 per year ($250K for couples);
- and an additional tax on insurance executive's compensation.
- $70 billion more to states to temporarily Band-Aid the excessive cost of healthcare and try and blunt some of the adverse selection created by allowing the unhealthy to wait until they are sick before buying healthcare. This now brings this fund total up to $182 billion. This is the additional "bailout" feeding "Big Insurance" against which Senator Paul rails.
Here are the changes to the Senate bill designed to buy the vote of more conservative members:
- Health Savings Accounts can be used to pay for health insurance premiums allowing more people to pay for healthcare with pre-tax dollars the same way businesses do.
- Lower cost, slimmed down health insurance options could be offered and people could be eligible for tax credits to help pay for them so long as the carrier also offers a full, high-dollar, Obamacare plan as well.
- While the cuts to Medicaid will remain in place from the Senate's last version of this bill, new exceptions were created to funnel more taxpayer money from the federal government to the states in cases of a "public health crisis" whereby the declaration of a state of emergency would garner more funds.
Would this bet better than Obamacare? Yes in that it does eliminate the individual mandate, employer mandate and most of the taxes passed into law with the ACA. However, it further cements Big Government's marriage to Big Insurance in America and will ultimately lead to increased premiums and fewer choices for the American people. This is not a solution but a temporary Band-Aid on a terminally ill system.
