Paul Ryan asserts that more Americans would be uninsured under the House ACA replacement because enrollment numbers will always be lower in a non-coerced purchase environment. “We’re saying the government’s not going to force people to buy something that they don’t want to buy,”
The problem with this is that the best projections indicate that the "choice" to be uninsured will not be evenly distributed throughout the population. It will, instead, likely fall disproportionalitly on older Americans, the "non-elderly" pre-Medicaid crowd. This is likely because the premium band for age rating under the House bill is likely to raise health insurance premiums for older people considerably and at an amount likely not offset by the age-related health insurance purchase subsidy program.
What do we call these people, Senator Ryan, "the old invincibles?"
It has been noted that the House ACA replacement bill (The American Health Care Act) has an inordinate focus on the need to rid Medicaid of the scourge of high dollar lottery winners. Roughly ten of the bill's sixty six pages ponder the need to change the categorization of lottery winnings to countable income for Medicaid eligibility purposes. As one article notes, this responds to an earlier independent push by a now retired Congressman to do this under the ACA. There would be savings, though -- depending upon the size of the lottery winnings -- the sojourn in the land of the over income for Medicaid might not be so very long and there are administrative costs to dis-enrollment and re-enrollment, if necessary.
Of all the topics to put at the center of the ACA repeal and replace, however, this seems the oddest of all. Is it the fear that somewhere someone may have gotten a windfall that you did not that prioritizes such thinking? Or, is it the knowledge that low income individuals disproportionately play the lottery? It is worth noting, that outside the American Health Care Act, great attentiveness to the lottery winnings of low income individuals receiving various kinds of public assistance has been kicking around for a while.
This puzzles me. Is the message that those receiving public assistance of any sort ought not play state sponsored and operated lotteries, as if these government officials do not know full well who keeps these state sponsored and operated lotteries afloat?