Many Democrats and liberal commentators remain upset that the Republican party has refused to embrace the Affordable Care Act, but in some ways that is a good thing. If/when Conservatives embrace the law we could end up very unhappy with the ultimate outcome.
This Politico column from Avik Roy from the Manhatten Institute is a perfect example why. From Politico:
It turns out that this isn’t true. Conservatives don’t have to repeal Obamacare in order to advance their principles. Indeed, it’s actually possible to take advantage of one of the law’s core provisions—its tax credits for the purchase of private coverage—to reform America’s entire health-entitlement behemoth, and to finally put the country on a fiscally stable trajectory.
Rep. Paul Ryan’s proposal to reform Medicare—giving future retirees “premium support” subsidies to shop for private health insurance—is, in fact, quite similar to Obamacare’s usage of “premium assistance” tax credits to offer coverage to the uninsured. So what if we used Obamacare to reform Medicaid and Medicare, by gradually migrating future retirees and Medicaid recipients onto a reformed version of Obamacare’s exchanges?
The basic plan is explored in more detail in a new white paper, but the general idea is to make the coverage on the private exchanges worse by reducing the tax credits, consumer productions, and minimum requirements. Then the plan is to effectively kill Medicare as we know it by steadily moving more and more people onto these private insurance ACA exchanges. Effectively it would replace one of the cheapest and most popular ways of provide coverage with a much more complex and expensive one that needlessly enriches private middlemen.
At some point the GOP will probably need to accept they can’t just repeal the law and start looking for ways to exploit how much effort Democrats put into defending its idiotic conservative design. It might seem hard to believe now but there is a real possibility Obamacare’s exchange will be the tool Republicans eventual use to try to achieve their long sought-after goal of killing Medicare.
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