More on what Senator Ron Wyden calls “Robin Hood in reverse”

This article by Liz Goodwin includes both republican and democratic reactions to the Congressional Budget Office's analysis of the Republican bill to "repeal and replace" the Affordable Care Act — that's the analysis that says millions upon millions of Americans will lose their health insurance under the bill. Goodwin's article also reminds us that the repeal is carried out in significant part by getting rid taxes on high-income Americans that the ACA uses to pay for, among other things, the ACA's insurance subsidies for low- to moderate-income Americans. That's why Senator Wyden calls the bill "Robin Hood in reverse."

Republican Majority Leader Kevin McCarthy is quoted as saying that "our plan does not force Americans to buy insurance plans they may not want or even need." That's true, sorta. The ACA's individual mandate requires people to buy insurance or pay a tax — as Chief Justice John Roberts explained in upholding the ACA's individual mandate. And it's true that the Republican bill would get rid of the mandate.

Sure, you can get rid of the mandate on the ground that, just like the Romneycare mandate in Massachusetts, the mandate infringes the liberty of people who don't want or don't need health insurance. And, sure, healthy, mostly young people may not want or need high-priced medical care when they are healthy and young. It depends what we mean by "need." It's arguable that everyone needs insurance, although the need for insurance benefits generally is not immediate for someone who is healthy. But of course, almost all people who are healthy and young will want insurance and need benefits later in life.

So, here's what McCarthy and other Republicans are saying: We are going to allow people who don't want or "need" health insurance to stay out of the risk pool — that is, they don't have to pay premiums or a tax in lieu of premiums if they don't want to, and they won't have insurance. Nonetheless, we promise that they'll get good coverage later when they have serious, pre-existing conditions. And the private insurance market is going to do this cheaply and with lots of great choices (to paraphrase our president), perhaps with a bit of help from a refundable tax credit (which is a form of public welfare benefit — so much for the free market) and expanded tax-free health savings accounts (which disproportionately favor the wealthy because the wealthy have money to put into the accounts in the first place and because their marginal tax rates are high).

Good luck with all of that.

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