The Republican health care bill makes no sense

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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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Ivan Escalante
based on our age but not our income ? What if a rich young person, who is made tons of money can have a lower health cost? While majority of young Americans, who are working on below or at poverty line !
Kevin Worldsavior
Wanna get rid of the Medical/Political Tyranny? - No problem at all! - Everybody will possess his/her own Health Care, once they start doing my discovery, that will keep us perfectly healthy all the time and by that make us Immortal - We humans can stop aging, ailing and dying (by wiping out all diseases) and live forever (like our Creators from the planet of Nibiru - The Anunnaki) - I got the key to our Biological Immortality - By staying absolutely healthy all the time - By Doing my discovery (just an exercise for a minute a day) - My WVCD - The Weapon of Virus and Cancer Destruction, that cures and prevents any diseases, known on Earth for millions of years, even radiation disease (concerning astronauts' lives on space missions) - I will describe my WVCD to everyone, who sends me a check for one million bucks - Everybody will stay absolutely healthy all the time, living their Endless Lives, for Infinite Health = Immortality and Salvation of the Human Race.
Funny b/c CONSERVATIVE states will suffer pretty badly b/c THEY are the ones with an over abundance of poor-azzbroke pucking rednecks who are now gonna lose their healthcare.


I actually hope that happens.
Casey Schofield
this bill is going to kill the Republicans in the next election. Now it's going to be harder for me to go see the doctor's I need to see all the dumb idiots voted for Trump we all are going to suffer for their choices. It would be great to get money out of politics
Comrade Everclear
And Obamacare did make sense? Tripling premiums and fining those who couldn't afford it made sense?

Oh wait, YOU DIDN'T READ IT! So you don't even know if it made sense.
Lee Johnson
The Trump National Health Insurance Plan is: Poor people have no health insurance, Billionaires pay no income taxes.
Lee Johnson
Obama knows what national health insurance is. He created Obama Care where most all of Americans had Health Insurance. Trump does not know what National Health Insurance is. Trump thinks National Health Insurance means poor people have no health insurance and Billionaires do not have to pay Taxes. Billionaires love Donald Trump who is one of their own.
Well, you ended with an easily answered question: Follow the money. Q: Who does it benefit? A: Solely the rich.
Sami Slimani
So long as you continue working within a privatised healthcare apparatus, you will always suffer from these issues. Universal healthcare is the only way forward.
Jay M
Health insurer Aetna Inc (AET.N) said on Wednesday (5/11/15) it will exit the 2018 Obamacare individual insurance market in Delaware and Nebraska - the two remaining states where it offered the plans. Insurers Humana Inc (HUM.N) and UnitedHealth Group Inc (UNH.N) have also pulled out of most of the government subsidized individual health insurance market. Looks like Obamacare Death Spiral is gaining momentum.
rocco rostagno
wtf are u talking about? obamacare has been on a death spiral. insurance companies dropping out left and right. premiums going up drastically. obamacare sucks..nothing popular about socialised medicine.
Man Of Refinement
It actually makes perfect sense. You just happened to conveniently omit about 80% of the bill.
Obamacare: Require everyone to get insurance so healthy people are just as much a part of the pool of insured as sick people. Prices stay lower because insurers win money on healthy people who aren't using their insurance and lose on the sick who pay a lower than they would have premium.

Problem: Subsidies for low income people cost a lot and raise the federal deficit considerably. Other insurers besides the government still can't afford to stay in business because the prices are too low. Other insurers leaving means higher prices and more subsidy payments.

What I Thought Republican Solution Was: Create an insurance market with free competition between state lines. More competition will lower prices and create more options. People will not be forced to buy insurance but many will now be able to afford coverage because prices are lower. Continue to protect people with pre-existing conditions so they can afford care. Subsidy payments to keep costs down are less necessary (except to those with pre existing conditions) keeping the federal deficit...and taxes? down.

This bill does not seem to be that solution. Correct me if I'm wrong by the way I'm really trying to understand all of this....
health insurance used to be something you got a good job to get.
now that you guys are insisting its a right it makes it more expensive for everyone.

and to top it all off you guys are probably totally cool with murdering children in the womb but are super concerned about people suffering under their life choices while burdening everyone else with the fallout.

oh wait... that's totally consistent with the short sighted me centered mentality of a bunch of self entitled children.
Stephen Emmanuel
Please Americans -- vote for folks that are smart and inspirational to run your country!! -- it's manic right now ... great job VOX for the analysis and insights
As a healthcare professional, I wish everyone bought insurance. With how expensive medicine is these days, insurance actually makes it cheaper. Also a lot oft he money we get come from the insurance companies so it helps us as well. Not getting paid enough can end up decreasing the type of care healthcare professionals offer. I know that sounds selfish but at least it better than people who dont want to help the rest of our less fortunate populations. I dislike when people say "I'm compassionate but....." yeah refusing to buy insurance that can then lead to helping other people is "compassionate". And honestly I feel anything dealing with healthcare always divides our country even more. Sigh is it too much to hope for a really good health care plan that at least 70% and up of the population actually agree upon?
thanh nguyen
just hate the music, it's a bit too loud compare to his voice. overall, good information :D
Don't agree with your last point. I really think that republicans were trying to address the issue of decreasing options for insurance in some counties, here is a link As to avoiding the Deathspirals, to keep cost low, people who are already sick shouldn't be buying insurance, defeats the purpose of insurance. As a taxpayer, I would rather help pay for these people healthcare instead of giving big insurance companies more money.
michael preston
No docs for Trump Chumps.
Danny Boy
"The point is to make their donors richer". I know you know the answer to your own question, I'm sure. You'll never get through that thick membrane on the right. They won't vote their interests. They won't hold their own party to task. Paul Ryan is a piece of filth.
Mr. Dark
clearly biased libtard
Brenda L
I like this guy.
哔哩 哔哩
The American government sucks cocky. Not America and Americans themselves, but the government.
Liza B
I suggest that the American people watch Congressional hearings/business .. foreign and domestic much worse than you think .....about everything...... ....
z planetx
We want competitive healthcare not MANDATORY healthcare....Trump, my hat
comes off to you....Thanks for keeping your word and the Hell with the
Communist Democrate party!!!.

Please deport them to N. Korea to
include some NWO Republicans... I have news for all Those in their death
beds... No amount of Insurance will ever save you. The price for sin is Death.
The price to save you Soul is Free for the taking..... get on your knees and experience
the power of a true Savior!!!

is a mighty God and the only real God, so too think that I need some Man to
take care of me and my Family is nothing but early death. We asked Obama for
government competitive Healthcare NOT MANDADORY healthcare. If you want
mandatory healthcare move over to those countries.

America we reap what you sow and when government gets involved, it become a
stumbling block in our Life. Socialist/communist, Hitler/Stalin/Mao type of
thinking will never work and is the root of all evil next to Money... Now
you know the rest of the Story!!!
D Storm
Obamacare was socialism, redistribution of wealth, and it was rammed through with a pack of lies.
Joshua Nelson
I done paying for the weak and jobless to have insurance. That's why I stopped paying for insurance and just take the hit on my taxes. It is cheaper for me. Screw Obamacare.
Mark Wilson
Good Job Mr President !
Peter Southern Boy
The ACA destroyed health care in my State and all of us just got sicker. We went from 7 insurers to 1. I can't use the insurance because it has an $8K deductible. I lost my doctor. Twice. This myth that Obamacare was working fine and the new bill destroys it is myth and partisan hype. The reality in my State is that ACA made everyone sicker.
Richard Smith
Maybe if Americans educated them selves on the constitution they would wake up!! To begin with the Federal government under the constitution has LIMITED authority. Health care is dedicated to the States and private enterprise. The Federal Government has ZERO authority to mandate any health care laws.
Gilang Akbar
this clear explanation is what many people needs. many trump sheeps still insist to praise trump because they themself have no idea what is the real problem is. all they know are only the outcome of the problem that is premium prices, "oh this is so expensive, booo, evil healthcare". they didnt know the actual system behind it, that it is not only responsibility goverment, but also need a lot of society contributions. education about this problem and many other politicals topic need to be pushed more to people, so that they will be more open and clear minded to know exactly where the problem is.
J Breezee
America got money for war, but cannot takecare of their own citizens. What a Damn shame
Capitol College Rocketry Club
Are you democrat?
then it must be a lot like obummer care
Charles Warren
Less is more. I like that idea, and republicans have my full support.
Jane Lin
"The Republican health care bill makes no sense"
The GOP healthcare bill isn't meant to make sense, it's meant to make dead people.
We are already in a death spiral...
Jay M
Healthy people should pay less for insurance not the same.
Lower premiums give people an incentive to be healthy.
Spoken like a true snowflake.
And it made sense when dems had to get it passed in order to see it. Please STFU vox liberal idiots
Taylor Colby
I need to leave this country.
Kekistani Patriot
1) Subsidies based on Age are better than by income because as a ACA participant, I have to constantly report any changes in my income during the year so that my subsidies can be adjusted. If I expect to earn 36K in the year, I qualify for subsidies but if I end up earning over $42K (approx), I am required to pay back all the subsidies while your employer provided plan is 100% deductible. So, if I make $42K I do NOT qualify for subsidies but my MANDATED healthcare premium is $500 a month with a $6500 out of pocket. ($12,500 before "fully-insured" kicks in). Being in CA, I pay 35-45% in taxes of that $42K as well as being mandated to pay $12,500 in healthcare so that I can offset those with preexisting conditions and all the women's health written into the plan.
2) You did not mention Cadillac Tax which if repealed (HR 173) would exempt high earners and benefit-rich public employees from being taxed 40% on excess value of their plan. This Cadillac Tax mechanism is designed to equalize plans or help fund ACA. Currently, employers are able to recruit and retain employees through benefits and receive 100% tax credit. Taxing these benefits would cause them to either equalize the value of plans and compete through taxable salary or fund national healthcare. Unions do not want healthcare equality as it would make them obsolete. HR 173 exempts high-earners and public employees from participation in ACA (approx. 175million). It is cosponsored by 79 Democrats.
This is the 1st step to replace and repeal Obama care. It's not the final result. It just takes the financial burden of millions insurance owners. The new health care plan has to pass the Senate again.
Eric Taylor
Also, why is there never a word for word line for line quote in any video like this? It is all interpreted by one person and then that opinion is spun into whatever that person wants to say it is. There is no sense of accountability as you have provided no portion of the bill itself in order for someone to compare to the accusations you are making.
Eric Taylor
It was never Constitutional to FORCE American people to buy something they didnt want. How can you support the individual mandate as an American citizen that is supposed to be free to make your own choices?
Ma tt
they want the immigrants to leave usa
get a job with benefits?
k odu
Racism not love for Americans is behind Donald Trump's obsession to repeal and replace Obamacare.
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