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Walker, Rubio Make Moves on Health Care Reform

Walker, Rubio Make Moves on Health Care Reform

Brace yourselves…ten-point plans are coming

If you’ve been craving red meat health care policy from the Republican candidates, hopefuls Scott Walker and Marco Rubio have something they’d like you to take a look at. This week both candidates introduced voters to their plans to repeal and replace Barack Obama’s controversial health care reforms with policies they claim will roll back government intervention while still protecting Americans from the effects of another health care overhaul.

Rubio’s plan is anchored by three primary components:

  • “Advanceable, refundable tax credits”—according to Rubio, he envisions these credits increasing in value, and would also include relief for employers who provide insurance.
  • Regulatory reform—Rubio wants to enable purchases across state lines, expand and encourage the use of HSAs, and implement protections for people with preexisting conditions.
  • Medicare and Medicaid reform—Rubio plans to implement a block-grant system for Medicaid funding, and craft policies that will transition future Medicare recipients into a system based on choice and free market competition.

Rubio announced this plan in an editorial for Politico:

ObamaCare is fatally flawed not just because it is poorly constructed, but because it relies on the outdated philosophy that the federal government can solve our problems through more spending, more taxes, more regulations, and more bureaucrats. The American people have been forced to be the test subjects of President Obama’s one-size-fits-all, big-government experiment, and have paid dearly for it.

For all of these reasons and more, I have fought against ObamaCare since I got to the U.S. Senate. I led the charge to stop its taxpayer-funded bailouts of the insurance industry and, fortunately, was successful in blocking them from taking place this year. But more must be done, and when I am president, repealing and replacing ObamaCare will be an urgent priority of my administration. Instead of relying on an outdated, big-government approach, I will utilize modern, consumer-centered reforms that lower costs, embrace innovation in healthcare and actually increase choices and improve quality of care.

Fellow candidate Scott Walker also unveiled his plan this week, touting its conservative-friendly reforms as a revival of promises to “repeal and replace” he says have been broken by members of Congress.

From CNN:

“People all across this country are fed up with Washington, I feel your pain, I’m fed up with Washington, too,” Walker said. “I think about this, we were told by Republican leaders during the campaign cycle last year that we just needed a Republican Senate to be elected to repeal Obamacare. Well here we sit, you know both chambers of the United States Congress have been controlled since January by Republicans and yet there’s not a bill on the president’s desk to repeal Obamacare.”

Walker, who has argued throughout the campaign that he is best positioned to win conservative reforms in Washington, recounted taking on legislative Republicans in Wisconsin when he won his first term as governor.

“I said to them the voters had told us they wanted is to be big and be bold,” Walker said. “As you can imagine, at the time, there were some Republican lawmakers who were kind of uneasy with the idea of taking on the status quo. I said it’s put up or shut up time.”

Walker’s plan also relies on tax credits; those aged 17 and under would be granted a $900 tax credit, and the grant would increase in amount to $3000 for those aged 50 to 64. Additionally, the new plan would offer a $1000 tax credit to anyone who signs up for an HSA; the goal of this, says Walker’s team, is to reduce premiums by as much as 25%. Similar to Rubio, Walker includes provisions protecting those with preexisting conditions from losing their coverage, or seeing spikes in their premiums.

The overall goal of the Walker plan falls in line with the campaign’s anti-establishment narrative—to slash and streamline the federal government’s place in health care. Walker plans on paying for the cost of his plan by making cuts to entitlement programs like Medicaid, and levying a tax on “Cadillac” plans.

Walker and Rubio aren’t the first candidates to release health care policy overhauls—Louisiana Governor Bobby Jindal offered his last year—but these dueling plans (and their dueling narratives) set up what could be the first substantive policy battle between this cycle’s candidates.

Substance—imagine that. Let’s have more of it.


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“Advanceable, refundable tax credits” are grants; giveaways. Call them by their true name: welfare. They are not the government letting you keep your own money, they are the government giving you someone else’s money. That doesn’t mean they can’t be justified, when they replace an even bigger giveaway. But let’s not kid ourselves about what they are.

    You’re right, they ARE giving one person someone else’s money.

    But how is that different than what we have RIGHT NOW?

    Unless you can ~successfully~ advocate for the Government to get out of the provision of health care entirely (which will never be allowed to happen by the proglodites) you will always have one person being “taken” from and another person being “given” to.

    Denigrating these plans as “welfare” is both deceptive and demeaning. Good attempt at Alinsky Rule 5 use though. Points for that.

    The key to these HSA structures (and to the FairTax structure of prepaid, refundable consumption tax credits up to the poverty line) is that they are UNIVERSAL. Everybody gets them, regardless of income, status, social standing, proof, etc….

    That (in theory) will make people act ~rationally~ as to how they spend their money, and will drive competition. Individuals will attempt to spend LESS than the “grant” in order to maximize the value of the money received TO THEM. Those rational choices will drive marketplace products tailored to individual sub-groups, rather than the “one size fits all” disaster currently being attempted.

    Currently there is no true incentive for individuals to act in a rational manner to “shop” for health insurance or for individual health provider’s services. They, through their employers or through the exchanges, purchase a plan, and then use it maximally in order to justify the expense. If individuals had to spend the money “out of pocket” they would be far more tight-fisted with it, because that $200 that you might be charged for seeing a doctor because you have a cold and don’t want to go to work might be the new (cheap) TV that you want, or that new pair of shoes.

    That’s the concept behind HSA’s with “catastrophic” insurance plans: that YOU can manage your own money, save appropriately, and if something REALLY monumental arises the catch provision is there to prevent truly bankrupting illness.

      Milhouse in reply to Chuck Skinner. | August 19, 2015 at 11:39 am

      What part of “That doesn’t mean they can’t be justified, when they replace an even bigger giveaway” did you not understand?

      Everything you say about it is true, but it’s still welfare. It’s like Milton Friedman’s “negative income tax”, which was to be a massive giveaway of taxpayer money to everyone, but which was justified because it would replace all existing forms of welfare, and be cheaper. And because the giveaway would all be concentrated be one program, so it would later be easier to rein it in.

      geez, I cannot believe you’re going to make me take up for millhouse. You need to read what he wrote again.

      Anytime you take money from one person and give it to another it is welfare.

    Midwest Rhino in reply to Milhouse. | August 19, 2015 at 11:52 am

    I guess I don’t understand the terminology, or what Rubio is really saying. Are you saying if you file and owe no income tax, the IRS will send you a check for the “tax credit”?

    “Refundable” sounds like a deduction from taxes paid. I don’t know what “advanceable” means. It may mean you get the credit in advance of April 15th, but it is still only credited against income taxes due. idk. But a tax credit by simple reading would only be good for paying taxes, like a free ice cream cone credit is only good for that, not redeemable for cash.

    But anyone not paying any income taxes for a couple years would seem likely to qualify for Medicaid anyway.

      Milhouse in reply to Midwest Rhino. | August 19, 2015 at 12:31 pm

      Are you saying if you file and owe no income tax, the IRS will send you a check for the “tax credit”?

      Yes, that is exactly what it means.

      “Refundable” sounds like a deduction from taxes paid

      No. All tax credits are deducted from taxes paid. If a credit is refundable, it means that if it is greater than the tax paid, you get the rest as a “refund”. This is not some revolutionary concept, that is what the term has always meant in US tax law.

      “Advanceable” means you don’t have to wait until you file your tax return after the tax year is over to get your “refund”; you get it up front, and then it gets reconciled in your return.

        Midwest Rhino in reply to Milhouse. | August 19, 2015 at 12:38 pm

        OK thx for clarifying for me. You’re right, they should call it what it is. It’s not a “refund” if it comes from someone else.

          Twice in the same thread… Milhouse is correct. And of course it is nothing new. People that pay no tax have been getting “refunds” for a long time.

Too little, too late. More pre-packaged, sanitized and carefully nuanced wording that will not resonate with ordinary voters. I smell desperation in the air.

nordic_prince | August 19, 2015 at 10:29 am

Does anyone have enough balls to eliminate the mandate?

I’m sick of government telling I have to do this or that for my own good ~

    Milhouse in reply to nordic_prince. | August 19, 2015 at 10:39 am

    There is no mandate. There never was one. That’s the key point of the Supreme Court’s decision in the first 0bamacare case; the majority decided that mandates are unconstitutional, and 0bamacare had contained one it would have been struck down.

    It is perfectly lawful to pay the tax and not buy the insurance. Congress expected people to make that choice, and budgeted for the revenue the tax would generate. The tax is linked to your income, and is collected by the IRS. How does any of that resemble a mandate? Mandates are, by definition, not optional, and it’s expected that everyone will comply and thus nobody will pay the penalty. And they’re enforced by the agencies that enforce everything else.

      Actually, it’s better than that.

      It is perfectly lawful to not purchase health insurance AT ALL, pay exactly what you might owe in income taxes from withholding (or slightly less and pay the difference on April 15, and then give the government the finger when they claim you have a deficiency, because they can only “collect” that deficiency from your “tax refund.”

      No refund, no authorized method of collection, and no manner to bill the taxpayer.

        Milhouse in reply to Chuck Skinner. | August 19, 2015 at 11:35 am

        You can do that, and there’s nothing they can do to you, but I don’t think it’s technically lawful. You owe the tax, they just can’t collect it. But I’ll admit I haven’t read the text carefully enough to say for sure. And it makes no practical difference; if they can’t collect it, why pay it?

        In any event, it is certainly lawful to pay the tax and not buy insurance, and that’s what makes it not a mandate.

      nordic_prince in reply to Milhouse. | August 19, 2015 at 11:56 am

      Oh – excuuuuse me. “Shared responsibility payment,” then –

      A stinkweed by any other name would stink just as bad ~

        Milhouse in reply to nordic_prince. | August 19, 2015 at 12:35 pm

        It’s a tax. Call it that. It’s an extra tax on your income, on top of the two income taxes you already pay. Congress didn’t want to admit that it was raising taxes, so it came up with some other name, but a tax is what it is.

Midwest Rhino | August 19, 2015 at 10:35 am

I wish there was more emphasis on protecting policy holders from spikes in their rate once they get a condition, instead of protecting those that wait till they have a condition to get insurance.

People that wait till they NEED coverage to get it are just stealing from those (me) that paid in for thirty years and are completely healthy. My catastrophic plan rates have doubled under Obama, but an obese smoker druggie can (apparently) jump in my insurance pool when he/she develops some serious problem.

So being responsible is once again punished. The payout should at least be limited, and a health screening required before they force me, the long term “contract” holder, to fund those that jump in only when they have the short term need. That’s just transfer of wealth from the responsible (not wealthy) to the irresponsible. Or maybe they aren’t “irresponsible”, they’re just gaming the system that’s perverted by DC mandates.

    Ragspierre in reply to Midwest Rhino. | August 19, 2015 at 10:49 am

    “People that wait till they NEED coverage to get it are just stealing from those (me) that paid in for thirty years and are completely healthy.”

    But that’s ONLY true when you make ObamaDoggle’s assumption of NOT insurance, but a utility.

    In insurance, you pay the actuarial rate for YOUR risk. Each and every OTHER insured pays for the risk to the pool THEY present.

    We can easily lose track of what terms mean in the Obamic Decline, where so many things are perverted.

      Midwest Rhino in reply to Ragspierre. | August 19, 2015 at 11:07 am

      yeah, I chose to keep my old policy which they told me qualified (some did not). But I don’t really know that it protected me from those jumping in late, as I have hoped (and your informed response gives me a little more hope it did, though it still doubled, to pay for maternity benefits perhaps).

      But Blue Cross may be making up for their Obamacare mandate losses by raising premiums on my pool, actuarial tables be damned. I don’t know those details. Obama promised to make the insurance companies whole if they had losses imposed on them by Obamacare … hopefully I kept myself separate from that side of the ledger, but all the deal making leaves me skeptical.

Walker’s plan suffers from a number of problems that conservatives should be aware of as we consider how best to replace Obamacare. The core of Walker’s approach is a new, universal entitlement that every legal U.S. resident would be eligible for, regardless of income or need. In a February post for The Corner, I described some of the issues with this approach. (I am an adviser to former Texas Gov. Rick Perry, but the Corner post predates that affiliation.)

Most importantly, from a standpoint of political economy, creating a new, universal, multi-trillion-dollar entitlement will have significant unintended consequences. Such a subsidy will be extremely difficult to reform, in the same way that Medicare is, and for the same reasons: politicians will have a powerful interest in increasing the size and value of this universal entitlement over time.
—Avik Roy

I’m not a health-insurance wonk, and have no aspirations in that direction.

Seems to me we…

1. kill ObamaDoggle, and

2. open up the market for various forms of insurance (via deregulation) and savings plans, while MAYBE providing a pool for high-risk and existing condition coverage.

That simple.

Sammy Finkelman | August 19, 2015 at 10:45 am

This is basically an off the shelf plan, but the off-the-shelf legislatve proposals that have been introduced in Congress. Walker’s doesn’t at all take account of the fact that insurance risks differ by more than age. Rubio sounds like he’s got some afterthought that is supposed to take care of it.

But refundable tax credits are a good start. Obama managed to confuse McCain about that in a debate in 2008 by pointing that the tax credit was less than the cost of an insurance plan.

There’s a lot more that needs to be put into these plans. You need something that incentivizes insurance companies to charge the right price – but not higher. You need a much larger fraction of medical costs than now to matter at the point of purchase to the point where people doing MRIs advertise their prices to the consumer – yet nobody should be prevented by cost considerations from doing whatever he or she feels necessary.

You need a whole system of checks and balances and points where people don;t want to go but will if need be.

These proposals are actually not ready for the majors. Obamacare also, of course, was not, and it had the consequences of oits defects postponed.

    Ragspierre in reply to Sammy Finkelman. | August 19, 2015 at 10:52 am

    “You need something that incentivizes insurance companies to charge the right price – but not higher.”

    This is what we quaintly call a “competitive market”, which would be greatly enhanced by deregulation.

    It’s funny, but it works every time it’s tried.