The Republican health care bill makes no sense

vox.comvoxexplainObamacareAmerican Health Care ActTrumpcaretrump careamerican healthcare acttrump healthcaretrump health carerepublican healthcarerepublican health carehealth insurancehealth insurance marketplacemedicaidobamacare explaineddonald trumphealthcare billhealthcare reformgoptrumpbarack obamapaul ryanMitch McConnellhealthACAwhat is ACAwhat is AHCAAHCAaca 2016replace obamacarerepeal and replacehealthcare

The bill doesn’t know what problem it’s trying to solve.

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Republicans in the House have finally released a bill to repeal and replace Obamacare: the American Health Care Act. The GOP healthcare bill keeps some of the most popular parts of Obamacare, like letting young adults stay on their parents' health insurance until age 26 and requiring insurance companies to cover people with pre-existing conditions. 

But the Republican bill gets rid of the key element that made Obamacare work: the individual mandate. Now that people aren't required to have insurance, healthy people could leave insurance pools en masse, leaving sick people who are more expensive to cover.

Hypocrisy is a minor sin in politics, but still, it is remarkable how much of it there is to be found in this legislation. A core Republican complaint when Obamacare was passed was that the law delayed many of its provisions in order to reduce public outcry and manipulate the CBO’s score. The GOP bill is similarly aggressive with such tricks, delaying changes to the Medicaid expansion until 2020 and pushing Obamacare’s tax on expensive insurance plans out until 2025.

Because Republicans aren’t even trying to win Democratic votes, they’re stuck designing a bill that can wiggle through the budget reconciliation process (another thing they complained about Democrats doing). That means they can’t make major changes to insurance markets like repealing Obamacare’s essential benefit standards or allowing insurance to be sold across state lines. That last part is particularly striking, given that it was one of President Trump’s five demands in his speech last week. I’ve always been skeptical about the savings Republicans could wrest by changing those regulations, but now they can’t get those savings at all — which means sacrificing a key part of their theory of cost control.

This bill has a lot of problems, and more will come clear as experts study its language, the Congressional Budget Office release its estimates, and industry players make themselves heard. But the biggest problem this bill has is that it’s not clear why it exists. What does it make better? What is it even trying to achieve? Democrats wanted to cover more people and reduce long-term costs, and they had an argument for how their bill did both. As far as I can tell, Republicans have neither. At best, you can say this bill makes every obvious health care metric a bit worse, but at least it cuts taxes on rich people? Is that really a winning argument in American politics?

In reality, what I think we’re seeing here is Republicans trying desperately to come up with something that would allow them to repeal and replace Obamacare. This is a compromise of a compromise of a compromise aimed at fulfilling that promise. But “repeal and replace” is a political slogan, not a policy goal. This is a lot of political pain to endure for a bill that won’t improve many peoples’ lives, but will badly hurt millions. is a news website that helps you cut through the noise and understand what's really driving the events in the headlines. Check out to get up to speed on everything from Kurdistan to the Kim Kardashian app. 

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Phillip Glass
Dont recall this vid when Obamacare was shoved down our throats.... and subsequently has fallen apart with massive rises in premiums, less coverage, people losing their doctors etc.

Partisanship at its finest Vox
Ragnarok Sora
can we just have single payer now.
Iliesa Dakuwaqa
This guy tells us all the pros and cons about the new healthcare bill, why don't you make one in less then 90 days and see where your intellect takes you.
Louis Tedone
Yeah DT will change it from Obamacare to Trumpdon'tcare
Joseph Vergara
i thinks the best way to solve that problem is let the people choice what they like comprehensive or regular coverage insurance i that way we the people have peace of mind what we are going to pay and what we can afford, just like car insurance or home mortgage rather than the government choice for us...
Damon Lam
I have a new role model. If I have 1/100th the collective intelligence and insight at Vox I'll be happy for the rest of my life.
_ Gambetta _
lel they accidentally explained the Ponzi scheme.
Bob Rolander
We still have trillions of dollars for bombs though... Duh...
Freek Buttz
Why do many western countries have some form of universal healthcare while the Americans are still so sensitive about prehistoric social security systems
Paris Laughlin
I thought you were going to teach me the correct way?
ayy lmao
I am an expert in American politics beacuse I listened to the whole Hamilton musical;; and ;Obamacare had Obama on its name so it's sexist and Obama; has 5 letters on ;it the triangle ;has fine sides so (5*5)/ 3 = Doritos so Obama is a lizard and a poopy pants ;
Paris Laughlin
show me the right way and I will follow you. can you teach others the truth?
Khong Minh
Haha the way you threw the papers down at the end... I feel your frustration. Thanks for doing what you do. I need this to stay hopeful and sane.
The goal should be to get the unhealthy healthy instead of bringing in more healthy to pay for the unhealthy.
4:20 The point is to make more money to their buddies in medical industrial complex. Who will then give money "gifts" to their buddies back in government under the table. Wash, rinse, repeat.
Kids From Africa
vox=cnn=FAKE NEWS, SICK liberals
Jay M
Can anyone Democat figure what is wrong with someone else paying your bills?
I love how Ezra does the wonk equivalent of a 'mic drop' at the end of this video.
Dean Johnson
Ahh, but the Affordable Care Act makes perfectly good sense ... right?
It the Republican healthcare bill makes no sense then the ACA bill is madness incarnate.
One way they can help bring down costs is by capping the profits they're allowed to keep they are currently keeping billions which makes no sense when you compare that to the claims they deny and lower income and sick people who can't afford to pay those claims out of pocket
I come from the future and it is bad and getting worse. At least the bill failed at getting enough votes because Republicans are very divided. As to the question of what Republicans want, they WANT to make their donors more money and they don't care how many Americans they screw over to do it. I say if you really want to make a stand either vote for an independent of for someone who is not bought out by some corporation.
Empel Xorg
Actually he made it better, Obama plan was to force people into system and keep them in. Trump de-incentivizes leaving by raising insurance for people that wait to get sick to take advantage of insurance, but doesn't force it.
The obama care would have been repealed it altogether if they could but the judicial branch doesn't allow it.
Empel Xorg
That's because they couldn't repeal Obamacare care but they could only edit it.
Bamber Banbury
Islam the religion of terrorism worldwide.
a couple hundred dollars is not a SMALL FINE. Im not saying I supporting trump but your lying when you say Obama care has a small fine if you dont have insurance. Why do I need insurance Im 20 years old
O l i v e r !
The point is to perpetuate the narrative of politics in play.
Simple as that..

Amanda Bertelsen
Alright. Republicans. Heathcare can be done one of three ways. You have the Government pay for it (Medicare), Insurance pay for it (Obamacare) or you pay for it (Screwed). Healthcare costs money. Someone has to pay.

For insurance to work, as many as possible have to be in on it (which is why Obamacare has individual mandate). For Government to work taxes have to go up (Bernie suggests the richest pay the most), and if you pay for it...good luck.

The only other option for healthcare is people dying outside of ERs.

I have just outlined the left/right/center of healthcare reform. You will notice Obamacare is center.
Benjamin Griffith
I really don't understand Americans (Republicans in general). First they are horrified by socialized medicine. Yet they love socialized military. In fact the US is the worlds largest socialized military on the planet. So we are okay with socialized military and security yet we don't want socialized health care like every other modern country on the planet? Makes no sense.
Get rid of the insurance companies. We don't need a middle man to profit billions off of our health care (sick people). Stop health care from being profit driven. That creates greed not the care people need.
They used to attack social security and some still do. Yet the vast majority of Americans strongly support social security.
The US health care costs are at least 30% higher then the next most costly countries health care. Why? Big corporate profit driven CEOs. Years ago doctors ran hospitals not CEOs.
I'm all for capitalism and free market but there is a line. Too much of anything is bad. Crony capitalism is one of the reasons why we ended up in the most recent recession.

So basically Republicans don't support free market for our military operations (equipment yes very different) maybe that same thought should be applied to something in some situations much more important health care. Security means nothing if you are dead from cancer.
All you guys saying tax cuts on the wealthy is wrong, then think again. Let's substitute the word wealthy for hard workers and these hard workers didn't win the lottery or get handouts, but they took risks and kept on fighting. Now the people who aren't making as much money or aren't working as hard are requesting free things from the government, no the government that hard workers pay for. Now people don't want to take risks and work because they can get free money from the hard workers that pay for the government. The government doesn't care because it's not their money they worked for. Lowering taxes keeps the hardworkers working, the unemployed working because they need to contribute to society. Nothing is free because it all came from somewhere or especially someone
Andy M
Just One Opinion: This Government Healthcare is a TAX!!! Nothing provided by GOVERNMENT is less expensive, nothing!! The Insurance Industry simply just absorbs the taxes as profits and has NO incentive to reduce costs as a competitive entity.
James Shields
It doesn't have the Obama name on it, that's fine for a lot of republicans
Nate Who
my big thing is I would like Insurance when I have been fined I'm paying something so if they're going to fine me why can't they give me basic insurance
k odu
Americans foolishly think that Trump is a genius.
offer tax cut for healthy ppl , slash gym fee's, pay to be healthy?
Cute animation of Obama forcing healthy peeps to sign up for healthcare. 😩
Keeping It Real
I feel like it would have been successful if they actually spent more time and effort into it where it actually were to get improved.
El Guacamole
The tax breaks where essentially added to try and win over republicans who would rather the whole of Obamacare be repealed now and throw everyone off there healthcare plans

I wouldn't celebrate he may just opt to do what the republicans do want and just completely throw Obamacare recipients off the list.

Politically speaking I would just repeal. Because the average American leftwing or rightwing is a polarized idiot who votes on what they want to hear not what they will get and Obamacare recipients are mostly anti Trumpers who would never vote for Trump anyway so who cares?

Either way Obamacare will eventually collapse I didn't have faith in Trumpet or you left wing retards lmao I'll be right either way.
Priya K
Wow, so many likes. Are people, especially Trump voters finally coming to their senses?
It is hard to understand why americans don't like healtcare. It works if everyone pays a little and everyone is covered. There are always more healthy people than sick, so it works fine in europe why not in america? But as i watch this discussion i understand that americans love choices. Not when it comes to women and if they want to give birth to a baby, but when it comes to the important issue MONEY. But still i dont get why is it better to have the choice now and have no choice in the future. Cause when you are old you most likely will need healtcare and if the young and healthy people dont pay in, the old have no choice cause they cant affort healthcare. I understand why rich people dont like this and call it "socialism" cause they want make use of there money so they get better helthcare then ordenary people. A rich guy dont want to have the same coverage, he wants the best, so he wants choice. But why dont like Trump people healthcare?
mike mcewen
Why is the govt in health care ? Because they own the ins companies, thats all you need to know, Why did they bail out AIG for billions / thats your answer, the govt is corrupt and all you can babel on about is some dumb ass health care bill that the govt' shouldnt even be involved in, Wake up.
Your Boi Skinny Penis
It really sucks trump doesn't believe in global warning, doesn't pay taxes, and wants to make major tax cuts for Rich people
Dancing Deaddog
Regulation of health care and pharmaceutical costs needs to be priority one! It doesn't matter what happens with insurance plans if healthcare and medication prices continue to skyrocket out of control! Healthcare will never be affordable if it continues as is.The repeal of Obama care so far is nothing more than a name change. We should all be writing our representatives, congressmen, and senators demanding the focus be set towards healthcare and pharmaceutical regulation!
Louie Lowe
The fact is that as long as we have to pay For Profit insurance companies to cover our healthcare we will never have affordable healthcare for most people. When we see these insurance company’s CEO's making 30, 40 million dollars a year, where do you think that money comes from? From our premiums that we pay. Money that should be going to our healthcare but instead is going into the pockets of the CEO's, those under him and the stock holders. Medicare on the other hand is handled by the government and has no CEO's, other mangers under them our stock holders to pay money out too. Out premium for Medicare is only $108.00 a month. Can you imagine a 65 or 70-year-old person with a number of problems trying to buy health insurance from a For Profit insurance company? Premiums would be $2,000.00, $3000.00 dollars a month if not more. This is why we need a single payer program. Medicare for all. Get the For Profit companies out of the picture and let everyone have good healthcare at a good price. Remember, For Profit health insurance companies are not in business to give you good healthcare. They are in business to make as big as profit as they can for their shareholders and they do this by giving you as little coverage as they can.
Ryan H
They need to introduce a stronger cap on deductibles and premium cost. Regulate the insurance companies, they are not being fair.
Linda Hendon
The ONLY thing that is going to work is "medicare for all", single-payer. They may as well accept that fact.
luke kuehn
He is implying that the way to fix Obamacare is to take it further, that is, increase the individual mandate enough such that healthy people are actually compelled, or essentially forced by the government, to participate thus bringing mean morbidity of Obamacare participants down and thus overall cost per patient down. Sounds good in theory, but the problem is this WHOLLY undermines the concepts of capitalism and individual liberty which are pillars of American society. Remember the Supreme Court actually ruled that the government forcing the "purchase" of Obamacare was unconstitutional but for some reason allowed the same ends to be reached by allowing it to be renamed a "tax". There is no easy fix and I'm not sure what an effective fix would be, but what he seems to imply is shameful in my opinion.
Vogel Njreri
Why didn't they make a mixed up version of the cost-calculation? When you divide into income-classes you then could do extra-calculations based on the age.. So the poor young People don't have to pay the same as the rich young or old people.

But what am I even talking about..the new healthcare-bill was set up to comfort the rich class, such as Trump himself..

Greetings from Germany! :)
David Parent
Canada and most other Western Democracies have single payer universal system of healthcare paid thru our taxes. We have had this system in Canada since the 1960's and have never needed to change it. We Canadians must recognized just how super free and civilized our country is compared to our nieghbour to the south, United States. I believe any country that allows is sick and most vulnerable citizen lose healthcare coverage thru legislation is basically creating a situation of turning there whole country of the United States into a giant 'concentration camp' that is deliberately planning the mass murder of these sick and most vulnerable American citizens! I believe if this new Republican Healthcare legislation enacted to replace Obamacare throws off 24 million people from Healthcare coverage that they be charged under the International Court in the Hague with War Crimes and Crimes against Humanity for creating a system of mass murder of over 24 million citizens! And after being found guilty of Genocide at the International Court in Hague they're sentenced to death by Firing Squad. The perfect ending for a most evil Naziesque House leader Paul Ryan!!!
You make no sense
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