Kentucky U.S. Senator Rand Paul is not happy with the current Republican plan to replace the Affordable Care Act, otherwise known as Obamacare. The plan comes from House Speaker Paul Ryan and has the support of President Donald Trump.
Although Paul was in Louisville Monday, he is skipping President Trump’srally in Louisville Monday night, saying he was headed back to Washington to drum up votes against the repeal plan, which is headed for a vote Thursday.
“My hope is that it fails Thursday and that’s when the true negotiation begins,” Paul said at the St. Matthews Chamber of Commerce Monday morning.
The GOP repeal and replace bill would do away with the ACA's requirement that individuals have health insurance and large employers provide it.
The plan would also remove taxes that fund Obamacare and begin scaling back the Medicaid expansion in states like Kentucky that expanded the government healthcare program.
Paul has been one of the most vocal critics of the repeal and replace plan, calling it “Obamacare-lite.”
He said the bill doesn’t go far enough and he's hopes for a replacement that leaves no one in the individual market. Instead, people would pool together with others to buy coverage.
“Some of us want more market oriented competition choice, things to drive down price," Paul said. "And on their side, they’re saying we’ll give you half as much as Obamacare. So it’s Obamacare-lite."
Another sticking point for Paul: association health plans.
The Louisville Chamber of Commerce already offers a health plan to its members. The idea is the local chamber could come together with other chambers across the state and in other states to gain more market power for cheaper prices. People would also be able to form their own associations for the purpose of buying insurance," Paul said.
“That’s one of the best things we could do, and we haven’t been talking about that at all,” he said.
Association health plans are part of the Ryan replacement plan, but wouldn’t be included in the initial bill.
Paul is also a big proponent of health savings accounts. These are tax-exempt accounts that allow people to save money for health expenses, including surgery as well as basic doctor visits. Though someone making $50,000 a year would be able to save more than someone making $25,000 a year, proponents says the benefit of these accounts would still indirectly help poorer people.
Paul’s theory is that many more people would ask for prices up front.
“You call up the doc, what you do is drive down the price for everyone,” Paul said.
Health savings accounts are widely available today through employer-based insurance with high deductibles, meaning enrollees must pay anywhere from $500 to $4,000 up front before insurance kicks in.
For people with Medicaid, Paul said he likes the idea of block grants that give money to states to do what they want. And he said he's not against keeping Medicaid expansion, but cautions that would mean increasing state taxes to pay for it.
