Most Democrats would at least privately admit that they would eventually like to turn Obamacare into Medicare for all.
What Republicans are not admitting, however, is that they would like to do the opposite--eventually turn Medicare into Obamacare--but only for those over 65.
Republicans may not openly admit it, but that’s exactly what Paul Ryan’s budget seeks to do.
First, it seeks to repeal the ACA for everyone under 65.
Then, it seeks to repeal the single-payer system of Medicare for those over 65, replacing it with what is essentially an ACA-like exchange--vouchers, paid for by means-tested subsidies. Participants over 65, with our without subsidies, could then choose their health insurance plans on the open market.
I know the ACA is a complicated law with many popular reforms. But in terms of the big picture way of how health care insurance is provided under the ACA, Ryan's GOP budget plan seems to be eerily similar to how the ACA works now--except that the Ryan GOP budget limits this "service" to those over 65 and replaces a single payer system already in effect.
I wonder if Ryan plans to have that "open market" available on a consolidating website, or if he would prefer seniors to gain the "freedom" of being part of a high-risk group that is chronically ill with pre-existing conditions and trying to figure out for themselves what plan best suits their needs.
And since he's going to repeal the ACA, does that mean that insurance companies will be able to refuse health insurance to seniors with pre-existing conditions? (And as an aside, why is no one asking him this question?)
Perhaps he would say that Seniors with pre-existing conditions (the vast majority?) could remain with the Medicare option.
At this time, Ryan’s budget keeps traditional Medicare in his “exchange”—in other words, unlike the ACA he does provide a “public option.”
As ThinkProgress noted on April 1, 2014,
Ryan’s new Medicare proposal hews to the same basic structure as his previous premium support plans — in essence, a system of insurance vouchers. Under the plan, future Medicare beneficiaries would have the option of choosing between traditional fee-for-service Medicare or a list of private health plans and receive a subsidy to help pay the chosen policy’s premium.However, again according to ThinkProgress this option will end up being extremely expensive:
Ryan emphasizes that his proposal still gives seniors the choice of remaining in regular Medicare. But what he doesn’t mention is that his plan makes Medicare so expensive that millions of seniors will likely be forced to switch into the private plans. While Ryan employs a different type of bidding system for private health plans under his 2015 blueprint that softens his plan’s topline effect on beneficiaries’ costs, an earlier Congressional Budget Office (CBO) analysis of Medicare premium support systems found that plans such as Ryan’s would increase traditional Medicare premiums by a staggering 50 percent.http://thinkprogress.org/...
Ironically,Republicans also say that the ACA is a problem because it creates uncertainty in the market and an upheaval in the health insurance industry.
So why would they seek to create more uncertainty in the market, just as we are on a path to stability?
Why would Republicans want to turn Medicare--a widely popular program, even with their base--into the ACA--the type of system that is currently much less popular, a system that they continue to insist is unworkable and indeed doomed?
Why would Republicans want to turn Medicare into a system that is exactly like the one that they’ve already voted to repeal--over 50 times?
It's my job is to report and I'll let you decide.
But I will say one thing. If Democrats don’t pick up this ball and run with it, they really don’t want to win in 2014.