Yet another failed Republican health care plan: Column

About seven years after the Republicans promised to "Repeal and Replace" the Affordable Care Act, we have their replacement plan. It is not a coherent policy alternative but a mishmash of recycled ideas. It increases costs for Americans with pre-existing conditions, increases costs for the middle-class, and guts the Medicaid and Medicare program.

Consider core elements of the plan. The Republican plan strips away important consumer protections and standards for health insurance. It eliminates the 10 essential benefits of the ACA allowing insurers to go back to the days when they did not have to cover benefits such as prescription drugs, maternity care, and mental health care. It also repeals limits on out-of-pocket costs. Whats more, the plan subsidizes high-deductible plans, leading to increases in the average deductibles by more than $2,700. Because the plan eliminates subsidies for out-of-pocket costs for low-income Americans, their cost increase would be even greater.

It gets worse. The plan doubles down on Health Savings Accounts. Yet, according to the Government Accountability Office, HSAs primarily benefit wealthy people in higher tax brackets who get the tax advantages.

The ACA guarantees affordable coverage to sick people by prohibiting insurance companies from discriminating against them -- by excluding them or charging them exorbitant premiums. With its subsidies and requirement to buy insurance, a broad mix of people enroll in coverage, keeping premiums lower than if only sick people enrolled.