No, It Does Not Look Like the Republican Senators’ Health-Care Proposal Adds Up Arithmetically. Why Do You Ask?

Thinking a bit about Philip Klein’s coverage of Coburn, Burr, and Hatch…

My first two thoughts are: (a) this doesn’t add up, and (b) continuous coverage as a replacement for the individual mandate is a really bad idea…

Philip Klein: GOP Senators Unveil First Health Care Plan in an Obamacare World: Tom Coburn… Richard Burr… and Orrin Hatch…. Insurers would be barred from imposing lifetime limits… required to allow individuals to remain on their parents’ policies until… 26… allow… insurers to charge older Americans five times as much [as the young]… require insurers to offer coverage to anybody who has applied as long as they have maintained continuous coverage…. The theory is that this would offer some protection to those with pre-existing conditions without having… Obamacare’s full ban…. At the same time, the idea is that this would create an incentive for everybody to maintain their insurance coverage, thus negating the need for the individual mandate….

Instead of scrapping the employer health insurance tax exclusion, the proposal would merely cap it at 65 percent…. The savings generated… would be used to help finance tax credits to be offered to individuals earning up to 300 percent of the federal poverty level…. States have the option of automatically enrolling [people] in a default policy…. The proposal would also expand the use of tax free health savings accounts…. Instead of expanding Medicaid, as Obamacare does, the Coburn-Burr-Hatch proposal would reform it to give more flexibility to states and allow Medicaid beneficiaries the option of using their tax credit to purchase private coverage…

First: most obviously: the numbers don’t add up. Adding people to Medicaid is cheap compared to private insurance: you either wind up not doing much to provide coverage to the poor–and continuing the dysfunctional shell game of cost shifting and chronic diseases festering into critical emergencies–or you bust the budget wide open.

Second: there is a bunch of tweaking of ObamaCare around the edges: 5 instead of 3, 300% instead of 400%, 65% rather than the “Cadillac Tax” which starts out smaller but gets larger. Why “repeal and replace” if what you are going to do is tweak?

Third: the replacement of the individual mandate–if you don’t maintain coverage, we fine you through the tax code, and you can sign up for coverage in the community-rated pool next open enrollment–by a continuous coverage requirement–if you don’t maintain coverage you can never, ever get health insurance again and if you have an emergency the hospital (or the government?) takes your house, your car, and your children’s college funds (if any) The Romney people back in 2005 concluded that the individual mandate was a much better road to go down than a continuous coverage requirement. I would love to see if Coburn et al. have a reason for this other than that they have boxed themselves into condemning the mandate as Democratic big government rather than a Republican responsibility principle and are really wishing that they had not done so.