As anyone who has followed national politics the last six years knows, Republicans have a rather strong dislike for the Affordable Care Act (ACA), otherwise known as Obamacare. The GOP-controlled House has voted numerous times to repeal it.
So it should be no surprise that a candidate for the GOP presidential nomination would have a plan for a health-care program to replace the ACA. Wisconsin Gov. Scott Walker outlined his plan Tuesday during a series of campaign stops.
Walker says his plan would enable all Americans to obtain affordable health insurance, which is the goal of the ACA. But Walker's plan has a number of stark differences.
For starters, it would do away with the federal mandate – the requirement that all consumers obtain health insurance. This mandate, which survived a Supreme Court challenge, was something the health insurance sought when the ACA was drafted.
The Walker plan is built on two pillars; the existing system of employer-based insurance coverage and tax credits to help consumers purchase coverage. Walker said his plan would have five objectives:
- Repeal ObamaCare in its entirety.
- Ensure affordable and accessible health insurance for everyone.
- Make health care more efficient, effective, and accountable by empowering the states.
- Increase quality and choice through innovation.
- Provide financial stability for families and taxpayers.
Walker's plan would replace Obamacare's system of tax credits with another system of tax credits. Under the current system, qualifying consumers receive a direct subsidy that reduces the monthly premium of the policy. The subsidy is based on family income. Families that make above a certain limit can still obtain insurance but receive no premium subsidy.
Walker's plan replaces the income qualifier with an age qualifier. This, he says, provides more help to consumers at the time in their lives when they need it most.
“For example, a 35-year-old woman who makes $35,000 per year and has no children gets $0 in Obamacare subsidies – she’s too young and too middle class,” Walker says in the introduction to his proposal. “Under my plan, this same woman would receive a $2,100 tax credit that she could use to shop for insurance in the open market and put any savings into a health savings account.”
Walker says tax credits would level the playing field between those who purchase coverage through an employer and those who purchase it on the open market, expanding options and lowering costs for health plans offered outside the workplace.
“This would ensure people are not locked into their current jobs just to maintain health insurance coverage and give people the flexibility to switch employers or even careers,” he said.
Walker says there could be a smooth transition from Obamacare to his plan, called “The Day One Patient Freedom Plan,” but concedes there are complications. One big one is the fact that many people with ACA policies have actually been moved to the Medicaid rolls.
“Given that 70% of new Obamacare enrollees were covered through Medicaid in 2014, we must implement Medicaid reform when we replace Obamacare,” Walker said.
A change from the status quo would likely create new winners and losers. Kaiser Family Foundation executive Larry Levitt told The Wall Street Journal that providing tax credits based on age rather than income shifts more subsidy dollars to higher-income consumers and away from the poor.
One of the Obamacare provisions Walker's plan would keep is no denial of coverage for pre-existing medical conditions. Walker said no individual should fear being denied coverage, or face huge premium spikes when they get sick and then try to change jobs or insurance plans.