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Bill Roth headshot

Unmasking The Revised Republican Health Care Plan

By Bill Roth
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Whether you like Rep. Nancy Pelosi (D-Calif.) or not, she got the numbers right on the American Health Care Plan (AHCA) when she stated: "[Republicans] have no idea how to explain stealing $600 billion from working families’ health care to give more tax breaks to the richest people in our country."

The original AHCA reduced taxes on the 1 percent by reducing health care for lower earners. The political reality of such a plan explains why House Speaker Paul Ryan (R-Wis.) is now offering a “revised” plan.

But this new plan looks to be even worse for those who are not rich and not over 66 years of age.

AHCA reduces healthcare costs by hurting kids, students and the disabled


Critics say what's wrong with the Affordable Care Act (ACA, also known as Obamacare) is that it's not all that affordable. It funded health care for the poor by taxing the very rich.

But the Republican AHCA does not reduce healthcare costs. It eliminates the Obamacare tax on the richest at the expense of eliminating or reducing health care for the poor.

A key question is: Who are these poor people that will face reduced or eliminated health care to enrich the wealthy?

A third are children, amounting to almost 16 million kids!

A tenth, 5 million people, are disabled.

Students make up 7 percent of those affected, or 3.5 million people.

The net impact of the Republican ACHA is that millions of kids, students and the disabled get less health care while the most wealthy receive an individual tax reduction of $165,000 each.

Paul Ryan is buying votes by hurting the poor even more while enriching the wealthy


Rep. Paul Ryan proposed four reforms to the ACHA that appear designed to shore up Republican support, as reported by Jeff Stein of Vox:

  1. A “reserve” fund for older Americans. The original AHCA formula for calculating health insurance represented as much as a $10,000 per year increase in premiums for older Americans who are not yet old enough to receive Medicare. The new AHCA sets up a $75 billion fund to provide more tax credits for this group. But the catch is that the new AHCA language does not specifically say how the $75 billion will be used to help older Americans.

  2. Reduced Medicaid funding that further hurts the poor. As if the original AHCA was not devastating enough in terms of health care for the poor, the new plan further reduces healthcare costs through cuts to Medicaid.

  3. Accelerating tax reductions for the rich. If you ever need evidence of the power campaign contributions from the rich hold to influence legislation, then this is it. The new AHCA accelerates the reduction of taxes for the rich.

  4. Special deal for New York’s GOP delegation. This one is just good old fashioned vote-buying. The New York GOP delegation wants to stop their Democratic governor’s Medicaid plans. Ryan is giving them what they want in exchange for their votes for the AHCA.

Four steps to end our political nightmare over health care


Whether it was Obamacare or ACHA, our political efforts can best be described as a shell game. Politicians are not succeeding in reducing healthcare costs. Instead they are shifting healthcare costs and taxes between American demographic groups.

Perhaps instead of Ryan's suggestions, politicians should pursue these four steps to achieve reduced healthcare costs:


  1. Move toward an individual payer insurance system. This type of insurance system is how we buy home, car and life insurance. It is sold on a national basis by intensely competitive companies. It is price-regulated by state commissions. Health insurance is a national service that would benefit from lower costs and improved service if it was sold and serviced just like the rest of the insurance we buy.

  2. Reforming drug development and sales. The current system enables drug companies to charge Americans high prices to fund drug research while charging the rest of the world competitive prices. This system needs to be reformed to insure continued drug research while also providing Americans with access to the same lower drug prices the rest of the world receives.

  3. Treat unhealthy food and beverages like tobacco. Our health insurance cost crisis is a weight crisis. What we eat and drink is causing an obesity and diabetes epidemic that is bankrupting our health insurance system. As a nation, we have successfully addressed the cost impacts of tobacco use by taxing it and restricting youth access. It is past time we make a national commitment to doing something similar to reduce our consumption of sugar, fats, salt and chemical additives.

  4. Recognize the cost of death. Dying is expensive. Approximately a third of Medicare costs are incurred during the last six months of life. Oregon and Washington states have gone through the difficult process of passing end-of-life legislation that empowers people to live and die as they wish. As contentious as this process will be on a national level, it is a dialogue we can no longer afford to avoid.
Image credit: Flickr/Gage Skidmore
Bill Roth headshot

Bill Roth is a cleantech business pioneer having led teams that developed the first hydrogen fueled Prius and a utility scale, non-thermal solar power plant. Using his CEO and senior officer experiences, Roth has coached hundreds of CEOs and business owners on how to develop and implement projects that win customers and cut costs while reducing environmental impacts. As a professional economist, Roth has written numerous books including his best selling The Secret Green Sauce (available on Amazon) that profiles proven sustainable best practices in pricing, marketing and operations. His most recent book, The Boomer Generation Diet (available on Amazon) profiles his humorous personal story on how he used sustainable best practices to lose 40 pounds and still enjoy Happy Hour!

Read more stories by Bill Roth