Congressional Republicans released their budget proposal today. Called the "Roadmap for America's Future", the proposal builds on ideas proposed by Paul Ryan, and seeks to reduce or eliminate deficit spending by making large cuts in the federal budget.
Among the changes proposed are replacing the current single-payer model for Medicaid with one where the feds would provide a subsidy, pegged to income, for folks to buy their own insurance in private markets. Medicare as it is will be preserved for folks who are currently 55 or older. Folks currently under 55 (frex, me) will get the subsidy when they become eligible, normally at age 65.
The subsidy will initially average about $11,000. You get more if you're poorer, less if you're richer.
To put that in context, my wife and I are currently covered by my employer-provided insurance. We have a pretty good HMO plan. The total cost of that plan, for the two of us, today, is about $12,000.
Will our combined subsidies, adjusted downward somewhat due to our relatively high household income, be a reasonable replacement for our current plan, ten years from now?
I don't know. It depends on how much it's adjusted downward, and on how healthy we stay, and on what is and is not covered.
And it depends on how much the cost of health care rises over the next ten years. Which is sort of why I say the plan misses the point.
The reason health care presents a threat to the national budget and overall economy is not due to how we make insurance coverage available. It's due to *the rising cost of health care*. And I don't see that Ryan's plan addresses that at all.
Essentially, Ryan's plan defines a cap, tied to income, on what the feds will contribute toward any individual's health insurance costs in a year. That will certainly insulate the federal government from the risk of runaway health care costs.
But it does so by shifting that risk to the consumer of health care.