Republican leaders in the United States are planning to replace Obamacare, but John Oliver is worried. The Last Week Tonight host has looked at the talking points that Paul Ryan gave out ahead of the congressional recess, right now one of the best insights into what might actually replace the Affordable Care Act, and found some bad ideas for the new policy. In an episode that aired Sunday, Oliver went through the plan and fleshed out some of its broad-brush ideas, but it wasn’t easy.
“Every time you get near something resembling a Republican plan, it just seems to recede into the distance,” Oliver said. One Republican ad campaign promoting an Obamacare replacement guided viewers to a website called abetterhealthcareplan.com, where visitors were met by a few lines of vague text and an invitation to view the ad that took them to the site in the first place.
Nonetheless, Ryan’s points give some worrying hints at what’s to come. Here are six reasons why the Obamacare replacement won’t stack up to the original.
Refundable Tax Credits
These tax credits would be based on age rather than income, which could lead to the odd situation where a billionaire like Bill Gates will receive more tax credits than a young adult struggling to get by. Secretary of Health and Human Services Tom Price proposed credits that would grant $1,200 to 18- to 35-year-olds and $3,000 to those 50 and over.
“A tax credit that small helps cover your health insurance the way a thong helps cover your dad’s ass,” Oliver said. “It doesn’t, and there’s something that’s fundamentally wrong with that.”
Health Savings Accounts
These accounts would encourage people to save up for their own health insurance, but they’ve received a cold reception from the public. Senator Joni Ernst was booed at a town hall meeting when she suggested the idea.
“They’re great for rich people. They’re basically a tax shelter, but if you’re too poor to save, or you get sick enough to blow through what you saved, you’re not going to get covered, and you have that thong problem again,” Oliver said.
“A phrase perfectly designed to bore you,” Oliver said. This would essentially move Medicaid funding to the states from a percentage-based system to a block grant. If the costs start to rise, coverage is reduced. A study into Ryan’s previous block grant proposal suggested that as many as 20.5 million people could lose coverage.
This would isolate the sickest people into their own insurance groups. This would keep premiums low for people outside the pools, but the federal government would need to spend $178.1 billion to ensure premiums didn’t rise too much in the high-risk pools. But in his proposal, Price set aside just $3 billion over a three-year period.
Continuous Coverage Incentive
This serves as a replacement for the individual mandate, which penalizes people for not taking out health insurance in the first place. The incentive would instead mean that anyone that dropped coverage and then tried to pick it back up would face a penalty, but what that penalty would consist of is unclear.
“They are not keen to talk about details there,” Oliver said. “This is a subject so toxic they’d rather just go abruptly silent, much when you’re a white person singing karaoke and you realize, uh-oh, we have an N-word coming up!”
With the above five in mind, it’s worth remembering that President Trump promised something grand on the campaign trail. The Obamacare replacement he outlined sounded great, but the plan that’s coming to light pales in comparison to the major promises ahead of the election, not providing the coverage promised ahead of time.
“I am going to take care of everybody,” Trump said in a 2015 interview during the campaign. “I don’t care if it costs me votes or not. Everybody’s going to be taken care of, much better than they’re taken care of now.”
Watch the episode below:
Last Week Tonight airs Sundays on HBO.