According to widespread media reports, Senate Republicans are considering an amendment to the proposed Better Care Reconciliation Act from Texas Senator Ted Cruz under which, if a health insurer offered at least one Obamacare-like plan with community rating, it could also offer a plan in which healthier people would pay lower rates than the sick. Although this proposal might please conservatives otherwise worried that the BCRA is but “Obamacare-lite” and although it might mollify some moderates — if you like your Obamacare you can kind of keep it — it creates an “income cliff.” People who need expensive medical care will be far worse off if they make more money. Some additional modifications to the Republican bill could reduce this problem, but they are likely to be some combination of ineffective or expensive.
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