Paul Ryan
Credit: Gage Skidmore/Flickr

For over six years now we’ve been hearing from Republicans that Obamacare is a complete and total failure. It has been described as a government take-over of our health care system and dire predictions have been made about what it will do to both the costs of insurance and the economy as a whole.

We’ve also seen that one of the priorities for Trump, McConnell and Ryan is to repeal Obamacare. Thrown into that mix from Paul Ryan will be his long-time goal of getting rid of Medicare as we know it. When discussing the alternative, the Speaker always points to the agenda developed recently by House Republicans called, “A Better Way,” where they laid out their plans on health care. I decided it was time to take a look, since it is the best blueprint we have right now of what is likely to be the first thing on the agenda. Here’s what it says about Medicare:

Beginning in 2024, Medicare beneficiaries would be given a choice of private plans competing alongside the traditional FFS Medicare program on a newly created Medicare Exchange…Medicare would provide a premium support payment either to pay for or offset the premium of the plan chosen by the beneficiary, depending on the plan’s cost.

The Medicare recipient would choose, from an array of guaranteed-coverage options, a health plan that best suits his or her needs. This is not a voucher program. A Medicare premium support payment would be paid, by Medicare, directly to the plan or the fee-for-service program to subsidize its cost…

The Medicare premium support payment would be adjusted so that the sick would receive higher payments if their conditions worsened; lower-income seniors would receive additional assistance to help cover out-of-pocket costs; and wealthier seniors would assume responsibility for a greater share of their premiums. Health plans that choose to participate in the Medicare exchange would agree to offer insurance to all Medicare beneficiaries, to avoid cherry- picking, and to ensure that Medicare’s sickest and highest-cost beneficiaries receive coverage.

In other words, Medicare insurance plans would be sold on an exchange with subsidies (premium support payments) available based on income and a guarantee that insurance companies will provide coverage to anyone. That is exactly what provides as the cornerstone of Obamacare…the very thing these same folks rail about as being so ineffective. They actually have the audacity to go on to laud this kind of reform because it lets “market competition work as a real check on widespread waste and skyrocketing health care costs.”

I’ll let people who know more about actuarial science unpack what this might mean for the elderly on Medicare. But what they have written undermines everything they’ve said about Obamacare…the reform they are so intent on repealing.

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