Republicans are “moving so fast, with so little oversight” that the Obamacare replacement could have major structural problems, said Mike Kreidler, Washington state's insurance commissioner.
“We could actually see market collapse, certainly in the state of Washington, but I predict that that could even be across the country,” Kreidler said.
Kreidler said House Republicans are in a tough spot politically, trying to repeal and replace Obamacare at the same time.
“But what they wound up with does not spell good news” for Washington residents who benefit from the Affordable Care Act, he said.
Kreidler finds fault with several parts of the Republican plan, which was unveiled Monday.
Individual mandate: The GOP plan removes a requirement that everyone have insurance. Kreidler said healthy people may avoid buying insurance, meaning the cost of high-risk people can’t be spread out.
Medicaid: He said there would be significant cuts – and not only in rolling back the Medicaid expansion under the ACA. He said parts of Medicaid that existed before Obamacare would also be cut. He said a lot of people depend on these programs, “in Washington, hundreds of thousands.”
Subsidies: Tax credits would replace most assistance. They would be based on age, not income. “If you’re lower income, you’re going to end up with less of a subsidy than you have in the past,” Kreidler said. If you're older, you would get a bigger tax credit, but insurers could also charge you far more.
Kreidler said Republicans could have used the opportunity to improve Obamacare, but he doesn’t see that in this plan. He said the U.S. has to do a much better job of reining in health care costs – particularly drug prices. “That’s the number one driver for health insurance premiums.”
There’s a deadline coming up for health care insurers to offer their 2018 plans for Washington state. And Kreidler, the state insurance commissioner, hopes the new Republican health care proposal doesn’t scare them away.
Washington has been in this spot before: Back in the 1990s, an attempt at reform, and a subsequent GOP-backed repeal, led to the collapse of the individual health insurance market in this state.
A story from Seattle Times in January lays out what happened back then: "By 1999, it was impossible to buy an individual policy in Washington. Every insurer had pulled out."