A Side-by-Side Comparison of Obamacare and the GOP’s Replacement Plan

 More uninsured
The Republican plan to replace the Affordable Care Act would remove health coverage for an estimated 24 million Americans by 2026, according to independent analysis by the Congressional Budget Office. Lawmakers from both parties rely on the nonpartisan budget office to gauge the potential impact of legislation

Impact on deficit

The legislation also would reduce the deficit by $337 billion over the next 10 years largely from Medicaid reductions and the elimination of the ACA's subsidies for nongroup health insurance, the CBO found.

Changes in insurance subsidies

Who wins and who loses under the Republican proposal depends on a few factors, according to a Kaiser Family Foundation study. An American who is older, has lower income and lives in an area with higher premiums like Alaska or Arizona will lose out if the Affordable Care Act, also known as Obamacare, is replaced. An American who is younger, has higher income and lives in areas with lower premiums like Massachusetts or Washington may receive additional assistance under the replacement plan.

The subsidy system under Obamacare would be replaced with a new system that would provide less help to low-income people and those in high-cost areas.

Insurance mandate

Obamacare, for the first time, required Americans to have health insurance. That would no longer be the case.

Guaranteed coverage

People with preexisting conditions would still get coverage.

Under the Affordable Care Act

o   Americans are able to get health insurance even if they’re sick. This put an end to insurers denying coverage to people who have preexisting medical conditions

Under the GOP proposal

o   The House GOP plan would still prohibit insurers from turning away sick consumers


Expanded Medicaid coverage would cease and the funding structure would change.

Under the Affordable Care Act

o   The federal government and states share the cost of insuring the poor. The amount of money that Washington gives each state varies depending on how much medical care that state's Medicaid patients receive
o   The federal government is picking up almost the entire cost of expanding Medicaid coverage to low-income adults without children in the 30 states (and the District of Columbia) that have chosen to expand their programs

Under the GOP proposal

o   A fixed "per capita cap" would replace the decades-old current system. Each state would have a fixed amount of money every year for every person who qualifies for Medicaid. That amount would increase annually by a percentage linked to the inflation rate
o   The additional federal funding that covered expanding Medicaid would be eliminated by 2020

Insurance marketplaces

The insurance marketplace would be intact, but insurers could charge older consumers more.

Under the Affordable Care Act

o   The Obamacare marketplaces, such as, enable people who don't get health benefits at work to compare plans, just as they might compare hotel rooms or airline tickets online
o   All plans on the marketplaces must offer a basic set of benefits, such as hospital care, mental health services and prescription drugs

Under the GOP proposal

o   Insurers would be able to charge older consumers five times more than younger consumers
o   Basic benefits would largely be preserved
o   Insurers would still be barred from imposing annual or lifetime limits


Most of the taxes set up under Obamacare to pay for subsidizing insurance would be scrapped. The GOP proposal does not include any new tax to offset the loss of revenue.

Under the Affordable Care Act

o   Insurance companies and medical device makers, which benefit from new customers under the law, pay more taxes
o   Taxpayers with incomes over $250,000 are also taxed more

Under the GOP proposal

o   Medical device makers, insurance companies and wealthy Americans would all receive a big tax cut


The legislation also would reduce the deficit by $337 billion over the next 10 years largely from Medicaid reductions and the elimination of the ACA's subsidies for non-group health insurance, the CBO found. 

But while the Federal deficit is reduced, this just shifts these costs to the States. Which still hurts our economy and people who can least afford these costs or have no ability to pay for coverage. And people who are uninsured will still go to the hospitals when they are sick and get...

Thanks to the Los Angeles Times for this analysis.  


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