By Michael Aron
Chief Political Correspondent
The House Republican plan retains some of the popular features of Obamacare, like requiring insurers to cover pre-existing conditions and allowing dependents to stay on a parent’s policy up to age 26.
But it makes some dramatic changes. There is no more individual mandate — you don’t have to pay a fine if you lack insurance. The employer mandate goes away as well. The plan freezes Medicaid expansion at the end of 2019 and shifts more of the financial burden for Medicaid to the states. And it allows insurers to offer cheaper plans, like the old catastrophic or bare-bones policies.
Republicans say their plan creates competition that will drive down costs. New Jersey health care experts are skeptical.
“Before the Affordable Care Act, New Jersey had 1.3 million uninsured New Jerseyans. We now have 800,000 of them fully insured and my fear is that this plan will spike that number back up. Those folks will wind up back at New Jersey hospital emergency rooms where in fact that’s not the best place for them to be cared for. They need primary and preventative care. So I worry it’s a step backwards,” said Betsy Ryan, president and CEO of the New Jersey Hospital Association.
“Rand Paul called it Obamacare light and in some ways it is,” said Joel Cantor.
At the Rutgers Center for State Health Policy Research, Director Cantor says the partial withdrawal of federal support for Medicaid expansion will hurt lower income New Jerseyans.
“People who say find a job, go off Medicaid and come back later, the state wouldn’t be able to get the full federal match for them. So financially it really dramatically shifts burden to the states,” Cantor said.
The New Jersey Health Care Quality Institute is a non-partisan, independent think tank in Princeton.
Senior Director Tyla Housman says that the current subsidies offered under Obamacare are more generous than Republican tax credits are likely to be.
“With the proposed plan being that we shift from individual subsidies to tax credits, there is the likelihood that that amount will probably go down for the people that need it most,” Housman said.
She estimates the tax credit will be worth half the current subsidy.
And Cantor says low income people lose the most.
“It clearly is a redistribution of the federal subsidy for health insurance to higher income people from what we have now,” Cantor said.
Political reaction has been along party lines.
Republican Leonard Lance says, “This draft is the next step in replacing Obamacare with policies that lower costs for patients and expand choice and access.”
Democrat Frank Pallone says, “The Republican repeal bill would rip health care away from millions of Americans … and put insurance companies back in charge.”
President Donald Trump today embraced the bill.
This is the House Republican plan. Key senators are already balking at parts of it. Mark up in two House committees begins tomorrow.