The new Senate bill  1) Reduces the number of people eligible for subsidies, reduces the values of the premium subsidies, and lowers the cap on total subsidy expenditure;  2) Eliminates the individual and employer mandates;  3) Restricts coverage for abortion;  3) Ends the cost-sharing reductions — but not before paying insurers back for the money they’ve already laid out;  4) Gives states a great deal more flexibility in the waiver program;  5) Gets rid of a lot of Obamacare taxes;  6) Provides market stabilization funds;  7) Winds down the Medicaid expansion funding, but not as fast as the House bill; and  8) Converts Medicaid to a per-capita allotment rather than an open-ended entitlement.

The government’s price tag for a single-payer health care system would be astonishing. When Sen. Bernie Sanders (I-VT) proposed a “Medicare for all” health plan in his presidential campaign, the nonpartisan Urban Institute figured that it would raise government spending by $32 trillion over 10 years, requiring a tax increase so huge that even the democratic socialist Mr. Sanders did not propose anything close to it.

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Recall that under Democratic Governor Peter Shumlin Vermont committed to a single-payer for the state but had to abandon the effort in 2015. Why? The cost was staggering — $4.3 billion when Vermont’s entire fiscal 2015 budget, including both state and federal funds, was about $4.9 billion. That’s right: essentially doubling the size of the government.
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One of the biggest problems health care experts in Washington, D.C. make is that they think the whole world is about health care. If a bill addresses the health policy, they think, it’s a good bill. Well, health policy has a lot of spillover today onto tax policy (there are twenty new or higher taxes in Obamacare, employer provided health insurance is the largest single tax break, etc.), employment law policy, family policy, etc. If the Senate GOP is going to “get it right,” they need to consult with those who have seen the way the sausage has been made under existing laws. Nowhere is that more true than in the area of the crucial individual tax credit.

If they do not, those who fail to learn from history might just be condemned to repeat it.

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Senate Republicans reworking Obamacare are considering taxing employer-sponsored health insurance plans, a move that would meet stiff resistance but which would help make the tax preferences for health insurance more equal. The move could raise billions in revenue that could be used to help stabilize the fragile individual insurance market. But it could be politically risky, since it could expand the impact of GOP health proposals from Medicaid recipients and those who buy insurance on their own to the roughly 177 million people who get coverage through their employers.

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Democrats in California’s state Senate spent Thursday hemming and hawing over Senate Bill 562, the Healthy California Act. The legislation would create a single-payer health care system to cover all Golden State residents. This proposal would kneecap California’s economy and saddle millions with the life-threatening wait times, rationed care, and out-of-control costs that plague all single-payer systems. The Healthy California Program would cover all medical expenses without premiums, deductibles, or copays. Such a sweeping overhaul won’t come cheap. An analysis from the state Senate Appropriations Committee puts the cost of the plan as originally proposed at around $400 billion a year.
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The Trump budget assumes Obamacare repeal. On the tax side of this, it particularly assumes repeal of the 3.8% point surtax on capital gains, dividends, and other savings (known as the “net investment income tax,” or NIIT). There are approximately 20 other new or higher taxes in Obamacare that also will be repealed. Tax reform assumes they are gone before starting on a new system.

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Health insurers and small businesses are pushing their long-sought goal of abolishing Obamacare’s health insurance tax as lawmakers work to repeal and replace the healthcare law.

The tax is a priority for insurers even as negotiations have centered on the Obamacare repeal bill and federal insurance payments.

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In what will be a busy week in Washington, the Republican House hopes to take another whack at ObamaCare reform, a large chunk of which is Medicaid. As if this were not enough to handle, Donald Trump promises a “big announcement” Wednesday about his tax plan, which will likely include cuts in the corporate tax rate.

Let us stipulate that Medicaid reform and corporate tax cuts are both excellent initiatives. Done properly, each would offer Americans, including those at the lower end of the income scale, a better deal than they have now. Unfortunately, pitching health-care reform as the way to help “pay for” corporate tax cuts undermines the best arguments for both.

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The Wall Street Journal makes an important point today about a subset of the Obamacare repeal fight: the lobbying to repeal the law’s taxes, like the ones on medical devices and investment income for the wealthy. It gets more complicated to get rid of them, the Journal points out, if President Trump and Congress don’t reach some kind of resolution on Trumpcare. That would shift all of the lobbying for repeal of those taxes to the tax reform fight, which is already likely to be complicated enough.

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