Congressional plans to replace the Affordable Care Act leave many important unanswered questions, Professor Robert Field said during an interview aired by Knowledge at Wharton on Feb. 21.
“The biggest details is the little question of money,” Field said, noting that some proposals would base public subsidies for health insurance on a person’s age rather than their income. “Everyone’ expecting they’ll be less generous than they are presently under Obamacare, but we don’t know yet.”
Basing the amount of subsidy on a person’s age is problematic, Field said, noting that younger people with a low income might receive a lower subsidy than older affluent people.
“There’s an inherent unfairness,” said Field, the director of the JD-Master of Public Health program and a recognized authority on health law and health care policy.
Republican lawmakers have stepped up proposals to eliminate tax subsidies for employer-provided health care coverage, pledging that it would allow wages to rise, Field said.
“If this works as it’s intended, the employers would pay the money in wages,” Field said. ”We don’t know how that would work…the money they pay you as wages would be taxed, so you’d have less money to buy your policy with. They could have the effect of bringing down premiums. It probably would have the effect of making policies less generous than they are right now. It would have a profound effect on health finance and on health care provision because the flow of money would change.”
For many decades, Field said, economists and policy makers have been unable to find a system that costs less while providing more health care coverage, as President Trump has promised.
“If there is a way to provide more coverage for less money, then he’s got a brand new business line even better than resorts and hotels,” Field said. “If he’s got a magic formula, that would be amazing. It would be great. It would be huge…I’m a little bit dubious.”