Credit: 401k(2012)/Flickr Creative Commons

The GOP's Big Health Care Gamble

March 14, 2017

In January, in an interview with the Washington Post, President Donald Trump said he was working on a plan with the goal of “insurance for everybody."

But according to the Congressional Budget Office, the GOP's health care bill would leave 24 millions more without coverage by 2026.

"This proposal unambiguously leaves millions of Americans worse off," said MIT economist Jonathan Gruber, who was instrumental in creating Romneycare and the Affordable Care Act.

Gruber said Republicans promised the impossible when they told Americans no one would lose insurance coverage under their new plan. That's because the unpopular parts of the Affordable Care Act (like the individual mandate, requiring even young, healthy people to buy insurance) make the popular parts (like preventing discrimination against people with preexisting conditions) work.

"The [Affordable Care Act] is an intricate set of interlocking features that only works together. It's a three-legged stool," Gruber explained.

"It starts with preventing discrimination in the insurance market, which is wildly popular for good reason. Before the law, America was the only nation in the world where insurers could say, 'you're sick, I'm not going to give you insurance,'" he said.

"But you can't end that without bringing healthy people into the pool. You need the mandate to bring the healthy people into the pool," he said.

But you also can't legally require people to buy a product they fundamentally can't afford. That's where subsidies and Medicaid expansion come in, Gruber said.

Remove some of those pieces and you get the GOP's proposal, which does away with the individual mandate but may make insurance coverage inaccessible for millions.

"It's all an intricate system," Gruber said. "Republicans can't pull one leg away from that stool and hope it still stands."

To hear more from Jonathan Gruber, tune in to Boston Public Radio above.

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