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Expert’s take: Did the GOP really ‘expand’ Obamacare?

Expert's take: Did the GOP really 'expand' Obamacare?

The media would have us believe the Republican Party is trying hypocritically to expand Obamacare. Edmund F. Haislmaier, Senior Research Fellow of Health Policy Studies at the Heritage Foundation, sets us straight:

Briefly, is this true? Did Republicans really expand Obamacare? If not, what did they really do, and why are they being accused of expanding a law they hate?

This was not an expansion of Obamacare. Rather, it was the repeal of an Obamacare provision that discriminated against small businesses relative to large businesses and individuals. It doesn’t improve Obamacare, it simply exempts some Americans (in this case, small businesses and their workers) from one of Obamacare’s many unreasonable and unnecessary restrictions.

The background is that Obamacare includes another provision (left unchanged) that limits total enrollee cost-sharing (deductibles and copays) to the HSA qualifying out-of-pocket maximums (currently $6,350 for self-only coverage and $12,700 for family coverage). While that provisions is also unnecessary, it isn’t as onerous, as it doesn’t prevent insurers and employers from offering plans with deductible levels up to those maximums. Indeed, among the 36 states using the federally run exchange, insurers are offering 252 different Catastrophic level plans, of which 249 set the deductible for self-only coverage at the out-of-pocket maximum and 227 do the same for family coverage, and insurers are offering 815 different Bronze level plans, of which 53 set the deductible for self-only coverage at the out-of-pocket maximum and 82 do the same for family coverage.

However, the provision Congress just repealed went further by limiting deductibles to only to $2,000 for self-only coverage and $4,000 for family coverage—but only for small group plans. That was an additional, unfair burden imposed only on small businesses and their workers.

What is the next step in the GOP’s battle against Obamacare?

In the near term, Republicans should continue to look for opportunities to advance legislation that limits the damage caused to private markets by Obamacare, and preserves or expands alternatives to Obamacare. That way, there will still be a viable private market to build on once Obamacare is eventually repealed.

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