One Republican painted a drop in insurance coverage as a positive, if it was the result of ending Obamacare policies such as the insurance requirement that conservatives oppose.
“We’re not going to send an IRS agent out to chase you down and make you buy health insurance,” said Representative Michael Burgess, a Texas Republican who’s a medical doctor and head of the House Energy and Commerce subcommittee on health. “If the numbers drop, I would say that’s a good thing, because we’ve restored personal liberty in this country.”
Under Obamacare, insurers can’t charge people who are sick higher premiums, or deny them coverage. Under the GOP replacement plan, insurers would be allowed to charge more to anyone -- whether healthy, or with a pre-existing medical conditions -- who had a gap in their health insurance coverage. That’s designed to create a strong financial incentive for people to buy and keep health insurance, without formally requiring them to do so.
Access Versus Coverage
At the core of the Republican argument in favor of their plan is that it will expand access to insurance for those who want it, rather than expanding total coverage by forcing people to. The requirements for repealing the ACA mean it’s not possible to keep the same number of people covered, said Representative Trent Franks, an Arizona Republican.
“You can’t do that,” Franks said in an interview.
For the Republican plan to work, it needs to make sure tax subsidies get people to buy insurance who wouldn’t otherwise, said Rebecca Owen, a health research actuary with the Society of Actuaries.
“A perfect system encourages everyone to buy an insurance package,” said Owen. “It would not be a good thing to go back to the days of a large proportion of our population not having insurance.”
Doubts All Around
And there are doubts among Republicans about the plan, and whether it can gain enough support in their own party. “It’s a far cry from a conservative plan,” Representative Mark Meadows of North Carolina, chairman of the House Freedom Caucus, said on Wednesday. He said there remains no consensus among Republicans that this is the way forward, and few details such as what the law will cost.