Anyone? Anyone?

We are in a series looking at the recently published Republican plan for the ‘repeal and replace’ of the Affordable Care Act. Click here to find other posts in the series.

‘In 1930, the Republican-controlled House of Representatives, in effort to alleviate the effects of the…Anyone? Anyone?’

If you don’t recognize the line from Ben Stein’s brilliant portrayal of the ‘dull as a stump’ economics teacher in ‘Ferris Bueller’s Day Off,’ then we’ll assume the delivery does not translate to print.

I desperately need help from Stein today because the first part of the new healthcare plan deals with tax credits.

Oh, please.  Stick a fork in my eye.

And this is such a big deal, it will take more than one post to summarize.  I know, I know.  Already, you are making that same face as the student in the movie as Stein prattled on about the Great Depression.  Hang with me, I’ll do my best, but we’re going to have to talk about ‘advanceability’ and ‘refundability,’ so grab some caffeine.

The first thing any new health policy has to address is coverage for all the people who did not have it previously, but got it through the ACA, and now are being whipped into a fury to believe that evil Republicans are not only going to leave them without coverage, but also plan to infest them with the fleas of a thousand camels.

Fear-mongering aside, the gang currently in charge has no intention of suddenly leaving millions without coverage.  You can decide if that is compassion or smart vote counting, but regardless, here is the plan:

Wait, we need a brief pause to set the table.  The existing approach sends all of these folks to the ACA exchanges, where they receive subsidies to buy a highly specified and highly regulated plan.

I don’t know whether or not you heard, but this model isn’t working very well.  You know, out of reach deductibles, limited to zero options, plans that don’t include existing providers in the narrow network.  You’ve heard?  Good, we can move ahead.

So all of this – the exchanges, the subsidies, the penalties on people who do not buy coverage – gets tossed in the trash bin and replaced by an ‘advanceable, refundable, universal tax credit.’

Anyone? Anyone?

Unlike most of what I write here, those specific words matter a lot, so we’ll come back next time and address some of the critical concepts, but for now, what you need to know is that if a person is not eligible for health insurance coverage from their employer or the government (Medicare, Medicaid, TriCare) they will get a tax-credit to help them buy insurance on the open market.

Next time, a reformed redneck attempts to explain tax credits.

Yes, the apocalypse is near.


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Tim Coan, ALN’s CEO, writes an insightful and witty blog three times a week about a variety of topics relevant to independent physician practices.

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