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+--- Thread: Slate: "The Ryan proposal compels Americans to buy insurance—just like Obamacare does." (/showthread.php?tid=116432)
Slate: "The Ryan proposal compels Americans to buy insurance—just like Obamacare does." - Ted King - 05-04-2011
http://www.slate.com/id/2292901/pagenum/all/#p2
Ryan's roadmap would reshape Americans' access to health insurance mainly through two provisions, both of which pressure people to purchase private health insurance to an extent and through mechanisms that are materially indistinguishable from the supposedly toxic Obamacare mandate. One of these Ryan proposals—as yet little noticed by pundits or politicians—is almost an exact copy of a provision in the Affordable Care Act.* It would repeal the current exclusion from employees' income of employer contributions to their health insurance premiums, thus terminating the subsidized employer-sponsored group health regime that covers nearly 60 percent of all Americans. In its place, the Republican plan would substitute a refundable tax credit, to be provided to individuals who purchase health insurance (or to employers who purchase health insurance for their employees). When this new arrangement takes effect in 2022, the tax credit would be set at $2,300 per adult and $1,700 per child, not to exceed $5,700 per family.
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Like this Ryancare tax incentive, the "individual mandate" section of the ACA, which the White House calls the "individual responsibility" provision, constitutes a pay-or-play option. Beginning Jan. 1, 2014, when the ACA provision takes effect, individuals who do not qualify for exemption on hardship or other specified grounds, must either carry health insurance or pay a tax penalty as part of their annual income tax filing. The ACA caps individuals' penalty liability at 2.5 percent of household income above the filing threshold, or a flat dollar amount ranging from $695 to $2,085, depending on family size.
Under both provisions, the result is the same: People who choose to carry health insurance have a lower tax bill than they would if they chose not to. In terms of their respective potential impact on individuals' bank accounts and tax liability, the manner in which they affect individuals' financial incentives, and hence the constraining effect on individuals' financial choices to either buy or forgo health insurance, the two "mandate" provisions are identical. (Indeed, in most cases, the financial difference for the individual taxpayer made by the Republican tax credit would be greater—i.e., more "coercive"—than the ACA tax penalty.)
Re: Slate: "The Ryan proposal compels Americans to buy insurance—just like Obamacare does." - michaelb - 05-04-2011
I posted a link to that article in the thread below. While I think the fundamental point is well taken and true, it is also important to point out that as far as I can tell, having read all versions of this proposal (100s of pages and hours of time I would like back), there isn't actually any detail about how they would implement this "idea". To call it a "plan" is to grossly overstate what it says.
It does seem true that the only known way to implement this "idea" would be to impose all sorts of similar components to what is in the ACA, like a requirement for seniors to buy into something. Otherwise, healthy seniors would just wait to buy in until the last possible moment (medicare already includes significant penalty provisions for not enrolling when initially eligible).
Re: Slate: "The Ryan proposal compels Americans to buy insurance—just like Obamacare does." - Ted King - 05-04-2011
michaelb wrote:
I posted a link to that article in the thread below.
Oops, sorry, I missed that. (I've been traveling the last several days and I was perusing some threads too quickly I guess.)
While I think the fundamental point is well taken and true, it is also important to point out that as far as I can tell, having read all versions of this proposal (100s of pages and hours of time I would like back), there isn't actually any detail about how they would implement this "idea". To call it a "plan" is to grossly overstate what it says.
It does seem true that the only known way to implement this "idea" would be to impose all sorts of similar components to what is in the ACA, like a requirement for seniors to buy into something. Otherwise, healthy seniors would just wait to buy in until the last possible moment (medicare already includes significant penalty provisions for not enrolling when initially eligible).
Yeah, if you are going to try to cover seniors (or other people private insurers would generally rather not cover) but still want to have the coverage be private coverage, then some kind of mandate is going to be necessary (or else you get the opt-in only when needed thing you mentioned, which is not sustainable). If you care about sick people enough to want the government to help make sure they are covered, but don't want mandatory coverage, then you pretty much have to go with a public option to compete with private insurers or skip private insurers altogether and go single payer.
Re: Slate: "The Ryan proposal compels Americans to buy insurance—just like Obamacare does." - swampy - 05-04-2011
Seniors already "buy in" to their Medicare coverage. I currently pay close to $400 a month total between my A,B & D Medicare coverage and my Medicare private supplemental coverage.
Maybe Ryan is trying to show some bipartisanship and compromise by including a requirement that everyone purchase insurance coverage. You'd think the libs would be happy about that.
Re: Slate: "The Ryan proposal compels Americans to buy insurance—just like Obamacare does." - rgG - 05-04-2011
swampy wrote:
Seniors already "buy in" to their Medicare coverage. I currently pay close to $400 a month total between my A,B & D Medicare coverage and my Medicare private supplemental coverage.
Maybe Ryan is trying to show some bipartisanship and compromise by including a requirement that everyone purchase insurance coverage. You'd think the libs would be happy about that.
So, Swampy, would you rather have the Medicare coverage you have now, or a voucher system. Be honest, which one would you choose for yourself.
Re: Slate: "The Ryan proposal compels Americans to buy insurance—just like Obamacare does." - mick e - 05-04-2011
swampy is an educated consumer, so she'll be fine.
As for the millions of folks who might struggle in the marketplace under the Ryan plan? Well - just screw 'em.
Re: Slate: "The Ryan proposal compels Americans to buy insurance—just like Obamacare does." - michaelb - 05-04-2011
rgG wrote:
[quote=swampy]
Seniors already "buy in" to their Medicare coverage. I currently pay close to $400 a month total between my A,B & D Medicare coverage and my Medicare private supplemental coverage.
Maybe Ryan is trying to show some bipartisanship and compromise by including a requirement that everyone purchase insurance coverage. You'd think the libs would be happy about that.
So, Swampy, would you rather have the Medicare coverage you have now, or a voucher system. Be honest, which one would you choose for yourself.
The other critical question would be: do we want seniors to assume 100% of the risk and the cost of increased rates over time. So that $400 per month (this may be on the high side, so probably a fairly good combination of plans) would increase by 10% or more per year. The Ryan fantasy is that competition between private plans would reduce that overall increase in medical inflation, but we have seen almost no evidence of that in this country, over multiple directly parallel situations (including Medicare Advantage, Medicare Supplemental and Medicare Part D).
Re: Slate: "The Ryan proposal compels Americans to buy insurance—just like Obamacare does." - Mac1337 - 05-04-2011
Let me know when someone comes up with a plan to give me my entire healthcare premiums (myself +employer) and lets me go out and shop for my own. Does Ryan's plan do it? If not, I am not interested.
Re: Slate: "The Ryan proposal compels Americans to buy insurance—just like Obamacare does." - michaelb - 05-04-2011
Dakota wrote:
Let me know when someone comes up with a plan to give me my entire healthcare premiums (myself +employer) and lets me go out and shop for my own. Does Ryan's plan do it? If not, I am not interested.
That's called Obama's Affordable Care Act. Did you miss that memo?
Re: Slate: "The Ryan proposal compels Americans to buy insurance—just like Obamacare does." - rgG - 05-04-2011
mick e wrote:
swampy is an educated consumer, so she'll be fine.
As for the millions of folks who might struggle in the marketplace under the Ryan plan? Well - just screw 'em.
So is my 85 year old mother-in-law, college educated and always on top of things. Still at 85, even she has some trouble dealing with her Medicare statements and even the limited choices offered to her for supplemental insurance and prescription drug plans. How much harder would it be if she had to sort through 20 different companies sending her offers and options. We just don"t want to go there.
What do you do when Grandma shows up at the hospital and says she doesn't have any insurance because she didn't know she was supposed to do this or that? What do you do with the seniors who just have no clue about such things? As it is now, the part A of Medicare is virtually automatic. If you change that, we are all screwed. This is just a bad idea, period.