The new version of the Republican Affordable Care Act change bill draft looks an awful lot like the kind of draft moderate Democrats and Republicans might have cobbled together if Hillary Clinton had become president.
I can see why conservative free-market Republicans might dislike the draft. The draft includes new health savings account and health reimbursement arrangement provisions, and new anti-abortion provisions. But it really would create a different version of “Obamacare,” not a wildly different health care system.
I see some ACA supporters complaining that the age-based tax credit might be about one-third less rich than the current tax credit.
But, because the current tax credit is available only through the ACA exchange, and about one-quarter to one-third of individual coverage buyers get their coverage outside the exchange system, the total amount of tax support going to insurers would be comparable.
Right now, the fact that the tax credit is available only through the ACA exchange system is great for the ACA exchange programs, but it creates weird market distortions. In Colorado, for example, people who use tax credits to pay for coverage end up with much more expensive coverage than off-exchange buyers. For some levels of coverage, the net price exchange users pay after getting the tax credit is comparable to the price unsubsidized off-exchange buyers pay.
Maybe freeing the tax credit from the exchange system will ease those strange pricing distortions.