Oh joy oh joy! We get to talk about health care again.

So. We now have the Senate’s Better Care Reconciliation Act – that’s BCRA – and it’s a watering down or subsidizing up of the American Health Care Act – that’s AHCA – which itself was a clear start, but nothing more than a start, at partially dismantling the Affordable Care Act – or the ACA – which we all know is Obamacare.

Do you really want to go through all the changes in rather overwhelming detail? Read Christopher Jacobs’ review in The Federalist. If there ever was a healthcare policy wonk, he’s it.

Do you want to know what the “family glitch” is? Chris Jacobs helpfully explains it’s when members of a worker’s family do not qualify for subsidies if said worker qualifies for employer-based health insurance. Even if said worker’s employer-based health insurance does not cover his family members. Thus the glitch. Apparently the BCRA solves the AHCA’s family glitch problem. Did you know that the word glitch probably comes from German or Yiddish? And was first used to refer to engineering problems at Cape Kennedy around 1965? And yes, apparently the BCRA solves the family glitch problem.

Ah but it’s not just the family glitch that was solved. We also have Avik Roy cheering GOP Senators for diving into the details of the AHCA and like navy seals triumphantly emerging on the surface with the AHCA’s section 202 in hand. Section 202 of the AHCA you ask? It involves a transitional schedule of tax credits rather than the flat tax credit that kicks in regardless of income under Ryan’s AHCA, and that was meant only as a bridge between Obamacare and Ryancare. What did the Senators do? They made it permanent so that the tax credits in the BCRA now depend on income, rather than being flat. That means lower income workers get more subsidies for their health insurance compared to the House’s AHCA plan.

That means, according to Avik Roy, that low-income workers and near-elderly working poor will now be able to afford health insurance that they might not have been able to under the AHCA. That’s surely what President Trump meant when he said we need a plan that is less “mean” didn’t he? He knew all about section 202 of the AHCA, didn’t he? Didn’t we all?

Then again maybe we didn’t. Health care policy in America is fiendishly complex with conflicts between hospitals, patients, doctors, healthcare workers, insurance companies, employers, employees, independent workers, small business owners, local government, state government, and the federal government. And taxpayers of course, which is a term that covers several of the already mentioned groups. And all the other groups I surely forgot to mention.

No single plan can satisfy perhaps even a clear majority of these constituencies. But most of us don’t have the time, passion, or focus to clearly think through the countless trade offs that any health policy in America necessarily involves. But that doesn’t mean we shouldn’t try. Health care is fundamental, and Obamacare is unsustainable without serious reform/replacing, or without way more taxes and subsidies. Those two truths mean everyone has to do a little research and decide what they think about healthcare policy. For their own and the country’s good. And yes, it’s a pain.

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