RyanCare and the process that led to it is a subject right in Chait’s wheelhouse, and he’s written a couple very good posts about it. I recommend this post in its entirety, but I particularly like the punchline:
Eventually they had told the lie so long it became impossible for them to abandon it. And so Republicans have found themselves frantically scrawling out a hopelessly inadequate solution in order to meet a self-imposed deadline driven by their overarching desire to cut taxes for the rich. “Expanding subsidies for high earners, and cutting health coverage off from the working poor: it sounds like a left-wing caricature of mustache-twirling, top-hatted Republican fat cats,” writes the Republican health-care adviser Avik Roy. The caricature is true.
I genuinely can’t understand what Roy could possibly have been expecting. Of course any Republican health care plan was going to involve 1)fewer benefits to the poor and most of the middle class and 2)a massive upper-class tax cut. The already cartoonishly evil plan is being attacked by Republicans mostly from the right. What does he think his party is? Can he see how they’re living? How can he delude himself? And note that even his moderate, reasonable, thinking-person’s analysis celebrates RyanCare’s savage Medicaid cuts.
This post is also good. First, it’s right that while it’s good that Democrats didn’t fund the ACA entirely through debt like Republicans would have, the bad obsession with deficit reduction led to subsidies that were lower than they should have been, which is both bad policy and bad politics, and is one thing that needs to be corrected by the next Dem Congress if the ACA survives. It’s also good on Paul Ryan’s use of empty buzzwords to evade his naked class warfare:
In a press conference defending his health-care plan yesterday, Paul Ryan rattled off the same buzzwords he has been repeating for years. “It means more choices and competition so that you can buy the plan that you need and that you can afford,” he said. The plan creates “a better, patient-centered system,” and “gives people the freedom to buy the plan they want and can afford.”
If you don’t know exactly what all these terms mean — choice, competition, freedom, patient-centered — that’s fine by him. It’s better than fine, actually. It’s the point. All these terms are meant to complicate the real choice his plan presents, which is a very simple one: more versus less.
The most naked and revealing moment of Ryan’s press conference came when he was asked about why his plan provides a huge tax cut for the rich. You can watch his response, ten minutes in. Ryan scoffs and makes a dismissive hand gesture, like he’s been presented with an utterly frivolous objection. Then Ryan says, “Read the bill! Go to readthebill.gop!” and moves on to next question while he and his lieutenants share forced laughter at the absurd query.
And it’s not just politicians. Note how Megan McArdle deals with RyanCare’s upper-class tax cuts in an otherwise mostly critical post:
So who does like this thing? Well, um, I guess rich donors and the taxes-uber-alles wing of the conservative movement. The bill is pretty good on the tax side, in terms of repealing the squintillions of fiddling little taxes by which Obamacare helped fund itself.
As I already mentioned, it makes a lot of fiddling tax changes — restoring deductibility of health insurer compensation in excess of $500,000, repealing things like the tanning tax, ending the Medicare surtax on high earners, and so forth.
Some of you will see one change she
left out buries. I strongly recommend this Dylan Mathews post, which demonstrates that the biggest generator of tax revenue RyanCare would eliminate is a tax on investment income for households making over $250K (or single people making $125K). If you’re making more than $250K a year and would notice a 3.8% tax on your capital gains, you’re doing very well. And yet Republican orthodoxy is that giving you that money back by taking health insurance away from the less affluent should be a central policy goal. They’re just not willing to put it in those terms, because the vast majority of people correctly see this as monstrous. But this is what the Republican Party is.