Jeb Bush left repealing the Affordable Care Act off of his list of top policy priorities when he announced his candidacy earlier this summer. It seemed like a possible nod to the fact that after more than 50 repeal votes, two Supreme Court rulings, and one presidential election, at least one GOP candidate understood that the ACA is a historic law that is working for millions of Americans. No such luck. Today, Jeb unveiled a health policy proposal that is the exact opposite: another conservative effort to rip health insurance from millions who have gained coverage and take us back to the old, broken system of before. Here’s what you need to know about his plan:
High-energy on repeal. In order to make way for his “innovative” new plan, Jeb Bush would repeal the Affordable Care Act. While he vaguely suggested he would provide a transition for the more than 17 million Americans who have gained coverage under the law, he doesn’t seem to think details on what that would look like are important enough to include in his campaign’s health care plan. But the details are perfectly clear on what repealing the ACA would mean.
- More than 17 million people would lose their insurance. So far 17.6 million people have gained coverage under the Affordable Care Act. The Congressional Budget Office, or CBO, predicts that repealing the ACA would result in 19 million people losing their insurance coverage by 2016 alone. Many of those who would lose insurance are middle- and working-class or sick Americans who could not afford health insurance coverage before the Affordable Care Act.
- Women would be charged more than men. An important tenant of the ACA is removing “gender rating,” which allowed insurance companies to charge women more for coverage, deny coverage for gender-specific reasons, and offer plans that inadequately cover women’s health needs. Jeb’s plan would reinstate the old, broken system under which women paid $1 billion more than men each year in premiums for the same benefits.
- The federal budget deficit would increase by $137 billion. In his speech announcing the plan, Jeb said his plan would help achieve his signature campaign promise of 4 percent economic growth, ignoring the fact that according to the Congressional Budget Office, or CBO, repealing the ACA would cost $137 billion over 10 years.
Innovation Isn’t Just a Hashtag. Although Jeb claims that his health care plan is all about promoting innovation, progress on this front requires real reforms, not just a hash tag. To achieve real innovation, we need to encourage pharmaceutical companies to invest in drugs that truly improve care, while keeping costs affordable for patients. For example, the Center for American Progress’s plan would use independent research on a drug’s benefit to patients compared to other drugs to inform payment, so that prices reflect a drug’s value.
- Jeb blames the FDA, when he should be blaming “Pharma Bro.” Jeb accuses the FDA and government regulation of slowing down innovation, and wants to reduce regulation of the pharmaceutical market. But the recent example of Turing Pharmaceuticals, which jacked up the price of a 62-year old drug by more than 4000 percent overnight, shows that the current system is broken.
- Instead of allowing outrageous profiteering, we should be paying for drugs based on their value to patients. CAP has a plan to do just that, as explained in this new CNBC op-ed. CAP’s plan would link payment to a drug’s effectiveness, cap patient cost-sharing to improve affordability, and make sure that government subsidies for R&D are generating real returns for patients instead of just subsidizing corporate profits.
Rehash of tired, unworkable ideas. Jeb’s health care plan is nothing more than a rehash of old ideas. The so-called plan contains the same stale proposals that conservatives have been shopping around since there was an Affordable Care Act to talk about repealing. His plan is light on details, but where it is clear, the results would be disastrous for the American people.
- Block-grants Medicaid. In the announcement of his health care plan, Jeb touted his health care record in Florida, and proposed applying those principles to the whole country. Like many Republican plans before his, Jeb’s proposal advocates for block-granting Medicaid and giving states control of the program. This is just another example of how low-income Americans would be particularly hard-hit by Jeb’s plan. The Kaiser Family Foundation projects that block granting Medicaid could throw 14 to 20 million people off of the vital program. And if other states were to implement the ideas that Jeb did in Florida, working families could face disastrous consequences. In Florida, Jeb’s Medicaid proposal led to Floridians losing their doctors and their plans and a reduction in the overall quality of care received.
- Ties tax credits to age, not income. Jeb proposes providing tax credits to Americans to help pay for health care coverage. But like Marco Rubio and Scott Walker’s health care plans, Jeb’s proposes tying tax credits to age instead of income. This regressive tax system would harm low-income Americans who would not receive adequate tax credits to help cover the cost of their coverage.
- Removes protections for those with pre-exiting conditions. Thanks to the ACA, the 129 million Americans living with pre-existing conditions no longer have to worry about losing health coverage or facing significant premium increases simply because of their condition. Jeb’s plan would revert back to the old, broken system, by offering no coverage guarantee for people with pre-existing conditions. Under his plan, like under many other GOP proposals, those with pre-existing conditions would only be covered if they can afford to maintain continuous coverage. Otherwise they will be forced into the “high-risk pools” that have never proven feasible or affordable.
BOTTOM LINE: Jeb calls his plan the “Conservative Plan for 21st Century Health,” but in reality, his proposal is little more than a rehash of tired, failed, conservative policies. Instead of acknowledging and building on the ACA’s success, Jeb’s health care proposal would strip coverage away from millions of Americans, bringing back the unworkable system of the past. After more than 50 repeal votes, two Supreme Court cases, and years of partisan fighting, it is time that Jeb and his Republican peers acknowledge that the ACA is here to stay.
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