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U.S. House Speaker John Boehner (R-OH) (L-R) leads fellow Republicans, including Rep. Cathy McMorris Rodgers (R-WA) and Rep. Kevin McCarthy (R-CA), onstage for a news conference about their proposed deficit-cutting plan, at the U.S. Capitol in Washington,
No big ideas here.
The experience of seeing Obamacare and its disruption of the individual health insurance market has some Republicans rethinking one of the few substantive ideas they've included in their own "plan" to "reform" the nation's health care system. Their big idea is to replace the tax break both employers and employees get on employer-provided health insurance with tax credits to individuals.
Some Republicans are now worried that a GOP proposal to begin taxing health-care benefits offered through employers—which would affect some 160 million Americans—would cause market disruptions far more severe and expose the party to its own political peril.

The proposed tax change was proposed by President George W. Bush in 2007 and by Sen. John McCain as presidential nominee in 2008. A similar GOP plan in the House has 117 co-sponsors.

Now, some Republican policy specialists have started to advocate that the GOP instead adopt a more modest approach.

The idea does do one kind of positive thing, further severing the tie between employment and insurance. But that's only a good thing if there's a single payer option available as an alternative. As Republicans would have it, it could also increase adverse selection in plans that employers might continue to offer, if healthier employees end up deciding to look for cheaper insurance on the individual market. Republicans believe that the demand created by making employer-based health care more expensive and driving people to the individual market would make health insurance cheaper. Of course, Republicans also think that taking unemployment insurance away from people automatically creates jobs for them to fill, so there you go.

At any rate, there's one more Republican idea to "reform" health care down the drain. Pretty soon all they'll be left with is their favorite old chestnut, tort reform.

Originally posted to Joan McCarter on Tue Dec 10, 2013 at 01:40 PM PST.

Also republished by Daily Kos.

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Comment Preferences

  •  Tip Jar (28+ / 0-)

    "The NSA’s capability at any time could be turned around on the American people, and no American would have any privacy left, such is the capability to monitor everything. [...] There would be no place to hide."--Frank Church

    by Joan McCarter on Tue Dec 10, 2013 at 01:40:21 PM PST

  •  Call it the Highlander Reform: (5+ / 0-)

    In the end, there can only be Tort Reform

    With the Decision Points Theater, the George W. Bush Presidential Library becomes the very first Presidential Library to feature a Fiction Section.

    by Its the Supreme Court Stupid on Tue Dec 10, 2013 at 01:55:34 PM PST

  •  Agree 100% (3+ / 0-)

    There can be no attack on the employer provided health insurance tax break until a public option exists.

    •  Even to replace it with an individual break? (1+ / 0-)
      Recommended by:

      Why does that need to wait?

      I support the public option all by itself, so you certainly don't need to sell me on that policy, but what's the connection to employer tax break vs. individual?

      Art is the handmaid of human good.

      by joe from Lowell on Wed Dec 11, 2013 at 10:26:44 AM PST

      [ Parent ]

      •  For those of us that have insurance through work (0+ / 0-)

        it would increase the amount of time we have to worry about our insurance.  Anything beyond the HR department saying "Here's your insurance card and plan information" changing to the federal government saying "Here's your insurance card and plan information" seems like a needless amount of hassle.  

  •  Why is it only a good thing with single payer? (2+ / 0-)
    Recommended by:
    scott jones, HeyMikey

    Obviously, having single payer is a good thing all by itself, and it would make this proposal better.

    But even absent single payer, wouldn't moving people from employer-based insurance purchased from a private insurer, to individual insurance purchased from a private insurer, be a good thing in and of itself?

    Art is the handmaid of human good.

    by joe from Lowell on Wed Dec 11, 2013 at 10:21:43 AM PST

    •  A public option would result in a pool (0+ / 0-)

      big enough to offset the loss of an employer's paying 50% or more of an employees' health insurance cost.  That's why there would need to be a public option, but I'm not sure why single payer would be necessary.  Single payer wouldn't make it necessary for anyone to have a tax credit for purchasing health insurance, but it would necessitate a rise in income or Medicare taxes in order to pay for it.

      "In this world of sin and sorrow there is always something to be thankful for; as for me, I rejoice that I am not a Republican." - H. L. Mencken

      by SueDe on Wed Dec 11, 2013 at 10:42:31 AM PST

      [ Parent ]

      •  D'oh, I meant public option! (2+ / 0-)
        Recommended by:
        HeyMikey, SueDe

        I get your point about the size of the risk pool, but isn't that what the exchanges are for?

        Art is the handmaid of human good.

        by joe from Lowell on Wed Dec 11, 2013 at 10:54:29 AM PST

        [ Parent ]

        •  A federal public option would result (0+ / 0-)

          in an enormous risk pool, much larger than one state (the state exchanges include only that one state's population), and give the federal government enormous leverage to limit health care costs - including pharmaceutical prices, if they'll do it.

          "In this world of sin and sorrow there is always something to be thankful for; as for me, I rejoice that I am not a Republican." - H. L. Mencken

          by SueDe on Thu Dec 12, 2013 at 04:31:50 AM PST

          [ Parent ]

    •  Exactly (2+ / 0-)
      Recommended by:
      untorqued, HeyMikey

      If I can't get single payer, at least let me pick my own insurance.  That way I can take it with me from job to job or change it if I don't like it.  I'm not just stuck at the whim of my employer.  I once had an employer that would change plans every. single. year.  It was annoying.

      Ron Wyden had a plan in 2008 to do this.  He would have required eliminated the group deduction and required all employers to "cash out" their group coverage: provide employees with raises equal to the amount formerly spent on the group plan.  Employees would then buy their own insurance on an "exchange"--all private, but at least playing by fair rules and be subsidized. Employers would also be required to pay a additional tax (about 6%) to cover the cost of the exchange subsidies.  

      •  agreed (1+ / 0-)
        Recommended by:

        And I caution my fellow Democrats not to make the same mistake that has painted Republicans into a corner: dismissing the validity of an idea based on the fact that the other side is proposing it. Remember, the health insurance reform outlined by the conservative Heritage Foundation only became toxic on the right when a Democratic president pushed to make it law.

      •  But in order to do that (0+ / 0-)

        you will need the individuals to be able to pool risk so they aren't cherry picked by insurers. You would then need to have consumer protections to prevent the sick from being screwed, and community rating to prevent them from being over-priced. But doing that would require standardization among plans and increasing the cost for the healthy. What about the healthy individuals who can't afford that increase?? Well, to offset that you would need to offer them subsidies based on income, and a mechanism to make sure the pool isn't prone to adverse selection. Something like say...a mandate.

        And then you have the affordable care act.

    •  I have had the same thought, but (0+ / 0-)

      the disruption is what worries me. The disruption of this change would be an order of magnitude greater than anything seen with Obamacare.  And major disruption in the healthcare system costs lives and suffering.

      Now maybe the pros outweigh the cons of getting off the employer-based system. I mean, more and more companies are reducing coverage and there is a tipping point where it's simply causing more of a divide between the better off and the less well off.

      Tens of millions of people without employer coverage get no deduction now because the floor is pretty high. In order to keep it revenue neutral (and there's little chance the deficit-fearing R's will propose something that grants net tax relief overall), a person with the median employer plan will no longer be able to deduct the full amount. This will be felt immediately in the paycheck for tens of millions of Americans with employer coverage. The fact that additional millions will now be able to deduct more, and that people have more choice will not be what the media covers.

      So politically, I'd FAR rather the republicans propose this. It'll make the current storm over Obamacare loss of coverage.look like a summer breeze.

      Want a progressive global warming novel, not a right wing rant? Go to and check out New World Orders

      by eparrot on Wed Dec 11, 2013 at 02:31:10 PM PST

      [ Parent ]

  •  If the Republicans get their tort reform passed (4+ / 0-)
    Recommended by:
    joe from Lowell, TDDVandy, SueDe, shoeless

    does that mean I will no longer be able to sue the bacteria and viruses which made me sick?

    •  You wouldn't be able to sue the doctor (2+ / 0-)
      Recommended by:
      shoeless, cybersaur

      who cut off your leg when it wasn't necessary and recover enough money to compensate you for resulting monetary losses for the rest of your life.

      "In this world of sin and sorrow there is always something to be thankful for; as for me, I rejoice that I am not a Republican." - H. L. Mencken

      by SueDe on Wed Dec 11, 2013 at 10:44:44 AM PST

      [ Parent ]

  •  I did not realize (1+ / 0-)
    Recommended by:

    that Republicans had ideas for health reform.

    29, white male, TX-07 (current), TN-09 (born), TN-08 (where parents live now)

    by TDDVandy on Wed Dec 11, 2013 at 10:28:20 AM PST

    •  This one's been floating around for a while... (3+ / 0-)
      Recommended by:
      Eric Nelson, shoeless, Mostel26

      ...and the reason that it's never gone anywhere is that it would be hugely disruptive.

      And considering the attempts by Republicans to hype the fact that several million Americans are seeing their individual plans discontinued, imagine what the impact of this proposal would be if it were ever actually implemented.  After all, while less than 5% of Americans are currently in the market for individual health plans, around half of us receive coverage through our employers -- and the Republican proposal would have driven a stake through the heart of those plans.

      How so?  Because absent any other regulation, the young and healthy would leave those employer group plans for cheaper individual plans, leaving those who have preexisting conditions or are nearing retirement in the group plans.  That, in turn, would cause the group plan costs to skyrocket, eventually to the point where those plans would cease to be viable.

      And since the Republican plan never included any protection for those who have preexisting conditions, that would have left tens of millions of people who now have coverage at work in a lurch, with no replacement coverage available at any cost.

      In theory, disconnecting health insurance from employment is a good idea.  Unfortunately, the details of the Republican version of this idea were such that it really, really stank.

      Political Compass: -6.75, -3.08

      by TexasTom on Wed Dec 11, 2013 at 10:36:28 AM PST

      [ Parent ]

      •  Sometimes disruption is good. (1+ / 0-)
        Recommended by:

        Even a busted clock is right twice a day, and I think I'm with the GOP (hard to believe I just typed that) on this one.

        The biggest obstacle to getting truly universal healthcare is that the GOP will be able to continue to split the middle class. Maintaining the divide between those with employer insurance and those on the Obamacare exchanges is a major split the GOP could exploit...and certainly will, if we give them time to realize it.

        Put all the middle class in the same boat on healthcare, and the middle class's electoral clout will ensure it's a good boat.

        Besides, most people with employer coverage only have a yes/no choice: your employer's plan or nothing. If it's a lousy plan, you're stuck with it. On the Obamacare exchange you can choose from several to dozens of plans.

        "The true strength of our nation comes not from the might of our arms or the scale of our wealth, but from the enduring power of our ideals." - Barack Obama

        by HeyMikey on Wed Dec 11, 2013 at 12:06:31 PM PST

        [ Parent ]

  •  I really don't see a difference between (2+ / 0-)
    Recommended by:
    untorqued, Eric Nelson

    an employer subsidy for you to buy AHCA and an employer tax on salaries to pay for AHCA.  Yeah, I know there are tax implications for the employer, but all that is just a side issue to funding health care.   When employers have no say in what my benefit plan is and have no ability to negotiate out my benefits when times are tough, that will be to my benefit.

    Ultimately, if I pay for my AHCA and so does my employer, through the tax system, we are well on our way to single payer.  It is only administration of the plans that gets in the way and it will be clear that taking the profit out of administering plans is the major remaining non-health related cost.

    We will never be free from fear as long as we fear the NRA.

    by captainlaser on Wed Dec 11, 2013 at 10:31:42 AM PST

  •  They haven't had a new idea since T. Roosevelt (2+ / 0-)
    Recommended by:
    shoeless, cybersaur

    was President.

    They are evil, stupid, and stuck firmly in the 19th century if not the 18th century.

    They suck and are an material and existential threat to most human beings.

    nosotros no somos estúpidos

    by a2nite on Wed Dec 11, 2013 at 10:34:11 AM PST

  •  Has the Republicans' brilliant idea (3+ / 0-)
    Recommended by:
    Eric Nelson, shoeless, cybersaur

    of "buying insurance across state lines" been sufficiently debunked yet?  That's another idea that should have been strangled in its crib, but it's more difficult to explain why to Republican voters.

    "In this world of sin and sorrow there is always something to be thankful for; as for me, I rejoice that I am not a Republican." - H. L. Mencken

    by SueDe on Wed Dec 11, 2013 at 10:36:02 AM PST

  •  Don't get Sick (0+ / 0-)

    If you do get sick - die quickly.

  •  Pray (0+ / 0-)

    What the matter, you got a problem with prayer? Huh? Huh?

  •  Slightly off subject but Marco Rubio of all people (0+ / 0-)

    has just showed himself what a hypocrite he his on Obamacare:

  •  Huge military impact (0+ / 0-)

    This will NOT play well with soldiers.  I could not build a plan on the Colorado site that was generous enough to replicate Tricare.  Closest I could come was about $2400 a month if you go with max deductibles and average number of visits requiring co-pay.  

    Thats $27000 in extra "income."  For me that will mean $5K in extra taxes.  That hurts but I can swing it.  Here is the problem - if you are a junior enlisted soldier that exceeds your actual pay.  An E-5 with between 4 and 6 years of service makes $2500 a month.  He/She would suddenly have to pay taxes on twice his annual pay - effectively a 100% increase in taxes.  Like most Republican tax plans it will hit the poorest the mostest because health care is not significantly different for rich or poor people.  

    Thanks Obama.

    It is well that war is so terrible -- lest we should grow too fond of it. Robert E. Lee

    by ksuwildkat on Wed Dec 11, 2013 at 10:48:35 AM PST

    •  I guess that's one of the parts of the law needing (0+ / 0-)

      to be fixed. You can bring that up to your elected representative or up your chain of command where they can bring it up to the brass level of DoD. Hopefully more stories like yours will come up and Congress at some point will make a fix on that. I hope for the best.

  •  "Insurance across state lines..." (0+ / 0-)

    That's their only "idea," which is really just a talking point that no one explains.  And the TV pundits never demand they explain it, either, just allow Republicans to keep dishing out the line about "buying insurance across state lines" without asking how that would work.

    If we could "buy insurance across state lines," can I get on Kentucky's exchange, 'cause Texas doesn't have one?

  •  I'm not sure I get it. (1+ / 0-)
    Recommended by:

    Whoever pays the insurance, it is an expense, and therefore not taxable, right?

    This would be a lot easier if insurance would not be tied to employment and insurance was replaced by a universal system. Cheaper too.

    I am not feeling the freedom here.

    •  No. Payment of insurance by employers (0+ / 0-)

      Is an expense to the employers, but in traditional tax analysis it is compensation to the employee and in a tax neutral world, the employer would withhold income tax, and both the employee's and employer's SS payroll tax obligation.  When compensation is provided in the form of health benefits, the tax law considers all of it to be "nontaxable" and exempt from wage taxes AND SS tax.  Yes, employers can deduct it as a business expense, just like they deduct wages to come up with taxable income, but the more wages get plowed into health benefits, the bigger the hit to the U.S. treasury via reduced payroll taxes.  

  •  Policy Schizophrenia . . . (0+ / 0-)

    If you think the screaming a few months ago about the cadillac tax was loud (cadillac tax is really just a "cap" on the amount of employer based health benefits that can be provided tax free), just wait until a cap of zero gets floated.  

    The tax treatment of employer based health benefits can be criticized -- for instance, it is protected from both withholding and SS tax, unlike wages and nearly all other benefits.  That means employers and employees are strongly economically influenced to plow compensation into health care benefits instead of wages, which does have an impact on the overall cost of health care in this country (it's indirect but real), and also magnifies the disparity in income between generations (young people use health care less and might prefer more of their compensation to be in the form of wages).  

    Hence the cap and its role in reducing the increase in health care costs.  

    But going to zero would be like a tsunami to current health policy.  Much better to make the cap get gradually lower due to inflation or something like that, so that it would gradually neutralize the financial benefit of getting insurance through employers.  

  •  Republicans and healthcare (1+ / 0-)
    Recommended by:

    Anything's better than that vulture Ryan's Coupons for Healthcare scam.

  •  Tax breaks for individuals might work (0+ / 0-)

    if you make enough money to file a tax return.

    The religious fanatics didn't buy the republican party because it was virtuous, they bought it because it was for sale

    by nupstateny on Wed Dec 11, 2013 at 11:25:53 AM PST

  •  Laura Meckler Wall Street Journal reporter.. (1+ / 0-)
    Recommended by:

    ..also has a good explanation of the reasons for GOP backtrack in this linked video  
    and this nails the GOP's fear:

    ..further severing the tie between employment and insurance. But that's only a good thing if there's a single payer option available as an alternative.

     - Joan McCarter

    and that is would also:
    ..making employer-based health care more expensive and driving people to the individual market

     - J McCarter

    One GOP fear is that the cancellations would skyrocket:
    "if you think 5 million people getting their health care cancelled wait 'til you see 150 million.."

     - Laura Meckler voicing the reservations she has heard from the right

    Also it would cause:
    ..severing the tie between employment and insurance.
     - J McCarter
    and that further exposes the need for:
    ...a single payer option available as an alternative

     - J McCarter

    Iow's it moves things toward everything that the GOP fears and has spent years lying about

    Also too: those cancellations, the very thing and one of the republicans main negative talking points, would be blamed on them and gone from their arsenal.

    But this:

    One of  the biggest flaws in their plan puts everyone in the more costly individual market, no group rates. Republicans just don't understand health care at all, or care too understand it.
    And from Neera Tanden, president of the Democratic-leaning Center for American Progress and an expert on health care, said:  
    "It is a great irony that there's been such stark criticism of the president for a small percentage of people facing lost coverage," she said, "when the traditional plans of the Republican Party on health care dwarfed anything that's happening from the Affordable Care Act."

    Nailed it Joan McCarter

  •  So tired of health insurance companies (0+ / 0-)

    and the contortions their politicians will go through just to keep these evil, profiteering arbiters of life and death around.

  •  The GOP has NEVER cared about healthcare reform (0+ / 0-)

    Liberals always point to things their elites have put on paper like the individual mandate, health savings accounts, and  high risk pools. But they've only put those things on paper in response to democratic initiatives making its way through the system.

    Whenever they've held power, these ideas weren't pushed because their underlying premise, that our health care system is broken, has NEVER resonated with their base. They're fine with the system as is, but because of the moral failure of the current system, they cannot have that public position so they put down "plans" on paper.

    A perfect example of the emptiness of their ideas is when Eric Cantor earlier this year tried to take funds from the ACA and divert them to high-risk pools, supposedly the republican answer for offering insurance to those with pre-existing conditions. The idea ending up dying with a wimper cause he had no support in his caucus, and conservatives were against putting ANY money into such a program, calling it things like Obamacare-lite. I'm surprised this episode doesn't get more attention, particularly from the left.

    Their plan is the current system, the sooner liberals and democrats accept and understand that, they'll better understand how to retaliate and push back against them.  

  •  Joan, it is "federally mandated tort reform" (0+ / 0-)

    When you mention "tort reform", please call it "federally mandated tort reform", because this brings home the point that while Republicans may claim to be all federalist and anti-mandate, they are trying to make states alter their court systems via federal mandates.

    The Republican Party: The Bridge to Nowhere

    by flounder on Wed Dec 11, 2013 at 01:14:27 PM PST

  •  mcmorris-rodgers (0+ / 0-)

    why is mcmorris-rodgers in all these GOP leaders pics? I never hear of her doing a damn thing other than repeating same old repug line and taking credit for other peoples work. Is she just the token GOP woman for the pic

  •  Employers used to offer health insurance... (0+ / 0-)

    to their workers as a way to attract and retain good workers. Now corporations don't give a shit about their workers.

    For far too long, they have been able to offer crap to their workers and workers had no real alternatives. Now with ACA, workers will be able to get insurance on their own, in some cases, get better insurance than that offered by their employer.

    Now a worker doesn't have to stay with a crappy employer for the sake of the insurance. It frees the employee to find better employment. Now, if only we can create better jobs to give employees a reason to stay working with a particular employer.

    To the world you are one person. To one person, you are the world. They can have John Galt, I'll take Joe Hill..

    by p a roberson on Wed Dec 11, 2013 at 01:22:25 PM PST

  •  Help Please (0+ / 0-)

    Please help us put pressure on our Governor to expand Medicaid (Phone number) 334-242-7100 or fax 334-353-0004

    Please help us put pressure on our Governor (Robert Bentley) to expand Medicaid (please use the phone number)   Please support the citizens of Ala. (Medicaid expansion) please sign the petition

    Here's his facebook page also (let him have it)

  •  tax deductible for all (0+ / 0-)

    Now that health insurance is a mandated expense for all, it is only logical that it should be tax deductible for all (up to the ACA maximum percentage of 9.5% I think). Very simple.
    Go and find the lost revenue somewhere else, with a modest change in tax rates for instance. Employers should still get to deduct the money because it is an expense for them equivalent to salary, salary that is being used to pay for one of the necessities of life.
    I'd like to see one of our progressive Congresspeople suggest that one.

    Bold at inappropriate times.

    by steep rain on Wed Dec 11, 2013 at 05:39:00 PM PST

  •  tort reform (0+ / 0-)

    I love it. As if tort reform isn't itself all about insurance? It's mainly insurance companies subrogating against medical practices, and the reason they know they can make money doing that is that the doctors buy liability insurance.

    Tort reform my @$$...

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