I am proud to be a Republican. But if there is one thing that really irks me about my Party it is the constant battle among our “leaders,” each of whom wants to state “I am more conservative than he/she is!” “I am a bigger budget hawk!” “I want to spend more for defense that Senator (fill in the blank) does!” And very important for this discussion, “I want to reform entitlements to a greater degree than (fill in the blank) does!”
I like a good argument as much as the next blogger. However, repealing and replacing Obamacare is necessary for the health (pun intended) of our nation.
Douglas Holtz-Eakin was Director of the Congressional Budget Office under President George W. Bush. He is a well known budget hawk. Furthermore, I would not describe him as a Trump “fan.” He was interviewed on the Journal Editorial Report regarding the repeal and replacement of Obamacare vis a vis the recent CBO report.
Regarding the 24 million who will “lose insurance” by 2026:
- We need to compare next year under Obamacare to the current Republican replacement plan
- Next year nearly all of Obamacare is intact, except that the mandate to purchase insurance has been eliminated by President Trump’s executive order.
- The same subsidies and the same insurance regulations will remain in place sans the mandate.
- CBO says 5 million will choose not to buy insurance.
- Further, 6 million will choose NOT TO PARTICIPATE IN THE FREE MEDICAID PROGRAM!
One must reasonably ask whether these 11 million have chosen this path because they see themselves as better off than they would be by purchasing Obamacare insurance or joining Medicaid? The logical conclusion is that they see the choice as better for themselves. A critical point is that Obamacare DOES NOT PROVIDE BETTER HEALTHCARE, just more insurance (and more expensive insurance with fewer choices, at that)!
The next point is that there is virtually no chance that Medicaid can survive in its current state for 10 years. It’s broke. Therefore, one would need to compare the next iteration of Medicaid to “Trumpcare,” not compare it to today’s Obamacare. As well, the original CBO report on Obamacare believed that in this coming sign-up period 12-16 million more Americans would get health insurance than did. Not exactly a stellar record.
So let’s look at the at the CBO prediction:
- 2 million fewer Americans in the individual market (essentially a rounding error).
- 7 million fewer in the employer market.
- 14 million fewer in Medicaid (but as noted above, Medicaid would necessarily need to change even if Obamacare was left intact).
Here is the most important takeaway! The CBO predicts federal spending on healthcare to fall by $1.2 trillion over 10 years (yes with a “T”). That is despite the fact that “Trumpcare” repeals $900 billion in taxes. The deficit would fall despite a large tax cut.
The budget hawks are all complaining that the Trump budget does not address entitlements. That is complete nonsense. Mr. Holtz-Eakin states categorically, “This (Trumpcare) is the single biggest entitlement reform ever contemplated!” Let us not forget that Obamacare is a massive entitlement. And let us not forget that Obamacare will implode.