My Thoughtful Critique of Trumpcare

Avik Roy has a request:

OK, here’s my Top 5 list:

  1. Medicaid: The Senate bill slashes spending on Medicaid in order to cut taxes on the rich. This is a cruel and unnecessary tradeoff for the richest country in the history of the world.
  2. Death Spiral: It eliminates the individual mandate; reduces subsidies for the poor; reduces benchmark plans to an actuarial value of 58 percent; and increases deductibles and copays. Whatever instability Obamacare currently has, this will make it far, far worse.
  3. Essential Health Benefits: Like the House bill, the Senate bill makes it easy for states to cut essential health benefits, which motivates insurers to offer low-end policies for the working poor that are worthless—but only if you read the fine print.
  4. More Uninsured: It will lead to tens of millions fewer people having health coverage. CBO will provide an exact number in a few days, but we already know it’s going to be big.
  5. Lifetime Caps: Guts protections against annual and lifetime caps, and because of the way the bill is written, it’s likely to do this even for employer insurance, not just for the individual market.

There’s more, like the substantial increase in premiums for older workers and the quiet kickback to insurance company CEOs. And what are the benefits? Unless you’re rich or you really, really want to cut funding for Planned Parenthood, it’s hard to see any.

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