A Minor Surprise In The GOP Health Care Proposal


There has already been a lot of discussion on a recent Republican proposal to replace Obamacare and I don’t want to repeat it all. The gist is that most people would pay more for less coverage and be at greater risk of losing coverage than under the Affordable Care Act. Reading a review in The New England Journal of Medicine I did find one item which I hadn’t noticed in previous discussion. (I don’t know if this article is available to  non-subscribers).

The proposal would also allow states to “auto-enroll” individuals who were eligible for premium tax credits in health insurance plans, effectively signing them up for coverage without their consent, though allowing them subsequently to opt out. States would be responsible for working with insurers to create auto-enrollment plans that could be purchased for the value of the premium tax credit. The proposal also assumes that the states could auto-enroll people in Medicaid.

Auto-enrollment is an interesting idea. Although it would be technically challenging, it could result in significant coverage expansion. It is likely, however, that in many areas people would be auto-enrolled in very-high-deductible plans with limited benefits.

I was just surprised to see any form of auto-enrollment included in a Republican plan. While you can still opt-out, such auto-enrollment sounds like the type of Cass Sunstein idea which Republicans were opposed to when he was working in the Obama administration.  In the end this is a curiosity but not very significant as their terrible plan isn’t likely to go anywhere.

In other health care news today, Gallup reports that the number of uninsured continues to fall. Over a  million more people signed up for health care coverage in January, including many younger people. I would expect this number to jump even higher as we approach the deadline.

Cross posted at The Moderate Voice

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