The Republican health care bill makes no sense

the wait is over Republicans finally have a bill to repeal and replace Obamacare I am holding it in my hand it is a real bill and it is stranger than I expected it to be there is a lot more of Obamacare left in this bill than I think anybody expected there are differences of course we'll get into those but there's a lot of popular parts of Obamacare Republicans now keep they are definitely working in an Obamacare world can continue on your parent's insurance until 26 that's still in there requiring insurers to cover pre-existing conditions check still in there

preventing insurers from setting lifetime limits check still in there tax credits so people can afford health care check still in there covering the people on Medicaid today it is in there now I don't want to overstate this there's a lot in the bill that changes huge huge tax cuts for rich people for one thing the tax subsidies the the way we help people forward insurance that's gonna be based on age not income and it's gonna be a lot leaner the Medicaid expansion that covers more than 10 million people now if you read this it stops adding new people in 2020 these details they will

change as a Senate and House argue over the bill but for this plan to work at all one thing Republicans have to figure out is how to bring healthy people into the system and here's why if you think of a group of people on a continuum from the healthiest to the sickest the sickest people they use the most health care so they're the most expensive to insure that's why to get a good mix of people to get premiums down on average you need a lot of healthy people signing up for insurance they use less health care so they pull premiums down for everyone this is the core question of insurance

markets how to have enough healthy people to balance out your sick people the reason this is difficult is it healthy people they don't need insurance as badly so when more sick people come on board and the prices come up it is a healthy people who leave without them the insurance gets even more expensive which drives out the next group of healthy people and so on and so on until insurance is completely unaffordable the way Obamacare tries to fix that problem is the individual mandate everyone has to either have insurance or they pay a small fine the Republican plan replaces Univision mandate with a provision

saying if you get sick and you need to rejoin the insurance pool insurance companies can charge you a 30% premium that's not gonna work already Obamacare's individual mandate is too weak to pull in as many healthy people as a lawn eating that's why premiums have been rising in a lot of markets this this is weaker it could lead to death spirals in a bunch of markets as healthy people flee and sick people are all that remain and make no mistake if they pass this mill Republicans will own these death spirals but that's just one problem in here look hypocrisy is a minor sin in

politics people are hypocritical all the time but it is remarkable how much hypocrisy there is to be found in this legislation remember when Mitch McConnell said this there are 25 million Americans who aren't covered now if the idea behind Obamacare was to get everyone covered that's one of the many failures in addition to premiums going up co-payments going up deductibles going up so after years of Republicans complaining that co-pays and deductibles are too high in Obamacare not enough people can afford insurance this plan the Republican plan it lets insurers

offer coverage with higher co-pays higher deductibles makes it harder for people to have it to actually use it and then not only make that insurance harder to use they make it harder to afford in the first place particularly for the poor under Obamacare the government gives subsidies to poor people to help pay their premiums the Republican plan it replaces these subsidies with tax breaks based on age not income and without the income based subsidies a lot of people aren't gonna be able to afford insurance the the credit rating agency Standard & Poor projects between six and ten million people will lose their

insurance under this bill a lot more would suddenly find the coverage they can afford has huge deductibles and doesn't actually cover that much that can go wrong the biggest problem this bill has amaura read it is it it's not clear why it exists what it's trying to achieve what it makes better in reality what I think we're seeing here is Republicans have lost sight of what they were trying to achieve in the first place they are trying so desperately to come up with something that will allow them to say they've repealed and replaced Obamacare they've let repeal and replace become not just a political slogan but a goal this this is Obamacare

light it's a worse version of Obamacare and it's a lot of political pain to endure for a bill that won't just fail to improve many people's lives but will badly hurt millions Republicans you need to really look at this and ask what are they trying to it 'chief here what is the point of all this [Music]