If you were among the few looking closely, you may have noticed buzz and hoopla this past week on the release of two health reform proposals from Republican presidential candidates Gov. Scott Walker (R-WI) and Sen. Marco Rubio (R-FL). Not surprisingly, while Affordable Care Act supporters were quick to criticize, ACA detractors were complimentary: “serious plans” and “the opening theme music of health policy reform for Republican presidential primary voters.”
So, how do these two plans stack up? Not well. Here’s a handy table with which you can compare – and I’ve left nothing of out:
| Category | Gov. Scott Walker | Sen. Marco Rubio |
| Title | The Day One Patient Freedom Plan: My Plan to Repeal and Replace Obamacare | Real Reform in the Post-Obamacare Era |
| ACA/Obamacare | “Repeal … in its entirety” | “Demand that we repeal Obamacare and replace it with a conservative solution.” (website) |
| Tax Credits to Purchase Health Insurance | “Available to anyone without employer coverage based coverage” – the amount based on age only:
0-17: $900 18-34: $1200 35-49: $2100 50-64: $3,000 |
“… advanceable, refundable tax credit that all Americans can use to purchase health insurance…” |
| Access to Health Savings Accounts (HSAs) | Anyone signing up for an HSA gets a $1000 refundable tax credit | “…should be expanded.” |
| Sale of Health Insurance across State Lines | Allow individuals to shop in any state for insurance | N/A |
| Pre-Existing Conditions | Banned for individuals who “maintain continuous creditable coverage” | “Those with pre-existing conditions should have access to affordable care through mechanisms such as federal-supported, actuarially-sound and state-based high risk pools.” |
| State High-Risk Pools | “…make it easier for states to expand these pools” | See above. |
| Mandated Essential Health Benefits, including for Young Adults <26 | “…return regulatory authority to states” | N/A |
| Medicaid | Capped state allotment for: 1. Low-income families 2. Non-disabled adults; 3. Long term services & support | “… move … into a per capita system preserving funding for Medicaid’s unique populations while freeing states from Washington mandates.” |
| Insurance Pooling | “… allow for new purchasing arrangements so farmers, small business, religious groups, individual membership associations and others could join together…” | N/A |
| Long Term Care Insurance | Deregulate the current market | N/A |
| Medical Malpractice | “… incentivize states to pass meaningful lawsuit reform…” | N/A |
| Financing | “… repeal all of ObamaCare’s $1 trillion in new taxes…” No specifics on substitute financing. | N/A |
| Tax treatment of employer provided health insurance | N/A | “Glide path” downward to match the value of individual tax credits within a decade |
| Medicare | N/A | “A premium support system, empowering seniors with choice and market competition, just like Medicare Advantage and Part D already do.” |
Some observations:
First, even for a campaign document, these plans are wafer thin, raising far more questions than providing answers. Walker’s plan has just seven pages of substance, and Rubio’s is based on two short op-eds for Fox News and Politico. Continue reading “Not Ready for Primetime: Republican Presidential Candidates on Health Reform”
Health Stew 