By: Elias J. Atienza

Senator Rand Paul (R-KY) has been one of the leaders in the GOP’s fight to repeal and replace the Affordable Care Act, known as Obamacare. He has rankled Republican Senate leaders by refusing to vote for a budget that would repeal Obamacare but not replace it, along with raising the debt by $9.7 trillion over the next ten years. Paul has unveiled his plan for replacing Obamacare that takes ideas from other Republican healthcare plans, while also dismantling most of Obamacare.

One of the biggest ideas he has is to expand Healthcare Saving Accounts (HSA) which would shift healthcare spending from employers to employees. As Cato Institute’s Michael Tanner explains in National Review:

“Paul’s expansion would allow much larger tax-free contributions to these accounts, and would allow them to be used for a wider variety of health-related expenses, including insurance premiums. That would mean that you — not your boss — would be able to choose your insurance plan. Expanded HSAs would also mean increased portability for health insurance. Because you could use your HSA to pay your premium, you wouldn’t be as likely to lose your insurance if you changed or lost your job.”
Another significant part of Paul’s plan is to open up competition in the health-insurance market. Non-traditional groups such as churches and civic associations would be able to sell health insurance to people, while also expanding association health plans. In addition, Paul’s plan would also legalize the purchasing of health-insurance across state lines and allow any person to purchase group insurance.

What is most likely going to the most controversial part of Paul’s plan is that he envisions getting rid of Obamacare’s pre-existing conditions rules, which forbids insurers from refusing to cover or charging more for people who are already sick. Some Republicans, such as Donald Trump, have supported the pre-existing conditions rule, which leads to concerns that this will “encourage people to game the system” along with having people get the best plans and specialists after they get sick because insurers are not allowed to refuse them or charge them more.

Paul’s plan seeks to eliminate the pre-existing conditions rule after a transition period while envisioning that those who are not covered after his reforms would be the responsibility of the states. Paul would borrow from Paul Ryan’s welfare reforms in block-granting Medicaid to the states so that they can experiment on how to cover people who are low-income and have preexisting conditions.
Senator Paul appeared on Special Report with Bret Baier to discuss his Obamacare replacement plan.

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