Above: Very Serious Policy Analysis
For some reason, the New York Times has given op-ed space to Avik Roy, so he can prove that you can’t spell “reformicon” without “con:”
In 2010, when Democrats passed the Affordable Care Act, Republicans complained that they did so with no Republican support. Democrats responded by pointing out that the centerpiece of their plan — tax credits to buy private insurance — came from a Republican governor, Mitt Romney of Massachusetts.
Yes, some people did make the very dumb argument that statutes passed by veto-proof supermajorities of Massachusetts Democrats were useful inidcators of healthcare policies that federal Republicans should like. This argument was, however, very dumb and also irrelevant to the merits of the BCRA.
But Roy needs to pretend that the BCRA is actually a bipartisan bill, so he will repeat the same fallacy twice!
The Senate bill’s plan to reform Medicaid by tying per-enrollee spending to medical inflation through 2025 and to consumer inflation thereafter was borrowed from a nearly identical 1995 proposal by President Bill Clinton. Indeed, the main difference between the Clinton proposal and the Republican one is that the Clinton proposal would have tied per-enrollee spending to growth in the gross domestic product. Historically, medical inflation has been higher than G.D.P. growth.
If you click the link, you’ll notice that Roy is leaving out some crucial context — Clinton’s terrible Medicaid proposal was made in the context of trying to preempt a far worse Republican one. But, anyway, yes, it was terrible! It was also more than 20 years ago. If you want to know what “Democratic ideas” about Medicaid are now, look at the comprehensive legislation passed by the Democrats the last time they had control of the government, and how they’re responding to the Republican proposals now.
Anyway, this idea that once any Democrat proposes anything it’s therefore permanently a “Democratic idea” whose inclusion makes any plan bipartisan is remarkably asinine. “Woodrow Wilson nominates James McReynolds as Attorney General, so really Jeff Sessions was a Democratic idea!”
The Senate bill replaces the A.C.A.’s Medicaid expansion with a robust system of tax credits for which everyone under the poverty line is eligible. Under Obamacare, you could enroll in private insurance exchanges only if your income exceeded the poverty line.
Well, yes, the ACA didn’t offer credits for insurance exchanges to people below the poverty line, because these people were supposed to be offered Medicaid. It’s regrettable that John Roberts ineptly re-wrote the Medicaid expansion, but any states that haven’t taken the money remain welcome to do it!
The idea that the replacement offered by BCRA is “robust,” meanwhile, is ludicrous. The insurance theoretically offered to the poor would involve such high deductibles as to be entirely useless — very few poor people would buy such insurance and even fewer people would keep it. Which is a crucial reason why the massive Medicaid cuts in the Senate plan would lead to huge numbers of people losing their health insurance.
The tax credit system employed in the Senate Republican bill is stronger than the A.C.A.’s, because it adjusts the value of the credits not only to benefit those with low incomes but also to encourage younger people to enroll in coverage.
Except, again, that the insurance that would be offered on the exchanges under BCRA would be worse and the tax credits much less generous, so the idea that large numbers of young people are going to buy insurance is silly. Lower premiums won’t be an incentive to buy and keep insurance if the deductibles are so high as to make the insurance useless.
If the Republican plan increases participation by the young,
If I had a billion more dollars I’d be a billionaire. So what?
Roy’s answer to the CBO analysis that 22 million people would lose insurance under the BCRA in order to fund a massive upper-class tax cut is quite simply pathetic:
It’s likely that, if the Senate bill passes, more Americans will have health insurance five years from now than do today. [100 eyeroll emojis — ed.]The Congressional Budget Office believes that solely because Republicans would repeal the A.C.A.’s individual mandate, by 2026, more than 15 million fewer people will buy health insurance, regardless of what senators do to direct more financial assistance to the poor and the vulnerable. That’s not a flaw in the Senate bill; it’s a flaw in the C.B.O.’s methods.
The flaw in the CBO’s analysis is that…it’s scoring the bill being proposed by Senate Republicans, as opposed to some hypothetical bill passed by a future Congress that would provide more generous subsidies for the poor rather than brutalizing the poor to pay for an upper-class tax cut. It’s embarrassing that Roy would type this shit and it’s embarrassing that the Times would publish it.
Roy emails back: “As a matter of policy, I don’t discuss with the press my conversations with policymakers.” So, if you’re curious whether he helped write the plan he has been touting in a number of op-eds and interviews, Roy isn’t saying, but “yes” seems like a fairly safe assumption.
I dunno, maybe the Times should make him answer this question before it publishes his feeble propaganda as if it was serious analysis?