But For Wales?…
I would say that Ramesh Ponnuru needs to decide whether he is going to be part of a reality-based technocratic conversation about the future of our social-insurance system, or a booster of individual politicians who evanescently catch his current fancy.
But that choice has already been made, hasn’t it?
Kevin Drum:
: A Conversation About Scott Walker’s Health Care Plan: “A Conversation About Scott Walker’s Health Care PlanRamesh Ponnuru thinks I got Scott Walker’s health care plan wrong…
…I complained that Walker’s plan would cost a lot but he doesn’t tell us how he’s going to pay for it without raising taxes. Ponnuru:
Walker says he is going to reform the tax break for employer-provided plans and get savings out of Medicaid….There’s no reason to doubt that some such mix could be made to work.
I tentatively doubt it. My back-of-the-envelope guess… Walker… [has a] hole… [of] $150 billion [a year] or so, since Walker would also repeal all of Obamacare’s taxes. The only proposal he offers to raise money for this is… the Obamacare Cadillac tax… [that] even in the far future it won’t generate anything close to [that]….
I complained that if you don’t have continuous coverage and you get sick or have a pre-existing condition, you’re screwed. Ponnuru: ‘At that point you’d have to go to a high-risk pool.’… High-risk pools aren’t a part of Walker’s plan. He just mentions them as a possibility that states might pursue if they want to. And anyway, high-risk pools are infamous for working poorly because they’re always underfunded. Would Walker really be willing to fund them at levels high enough to actually work?
I complained that Walker doesn’t tell us how he’ll prevent insurance companies from raising rates on people with expensive pre-existing conditions. Ponnuru: ‘A protection for people in the group market who have maintained continuous coverage has been law since 1996. Walker’s plan would just expand and strengthen that approach in the individual market.’ That’s possible, but Walker’s plan doesn’t say this. I can only respond to things Walker actually says. What’s more, the individual market is fundamentally different from the group market…. This is tricky stuff… [that] requires more than ‘just’ expanding and strengthening HIPAA…..Nickel summary: Ponnuru is right about the Cadillac tax pushing costs down. But I don’t think his other criticisms really hold water…. Aside from illegal immigrants, Obamacare really does try to give everyone a chance to buy decent coverage…. Walker’s plan, by contrast, doesn’t even try to cover everyone… by design. Maybe you prefer this. I don’t.