Sen. Ted Cruz (R-Texas), one of the most vehement opponents of the Affordable Care Act, has retooled an earlier healthcare proposal and, on Wednesday, cited approvingly an impact analysis that treated the plan as an amendment to the ACA -- in other words, an Obamacare fix rather than a straight repeal.
The plan would allow insurers to sell partial-coverage policies currently banned under the ACA, alongside policies that do comply with ACA requirements. It was part of the so-called Cruz-Lee "Consumer Freedom" amendment (co-named with Sen. Mike Lee, R-Utah) first offered in an attempt to salvage the Better Care and Reconciliation Act. But that version separated insurance purchasers into separate risk pools for the ACA-compliant and non-compliant policies. The new version establishes a single pool for all policies.
At least that's how it was described in an , which apparently had exclusive access to its details, citing a "source close to Cruz." The senator himself did not release the full text although he did issue a of the proposal prepared somewhere -- it's not clear where -- within the Department of Health and Human Services, also obtained by the Examiner.
Why was Cruz crowing about it? The HHS analysis indicated that, if the proposal were enacted today, enrollment in individual plans would increase by more than 2 million, federal spending to support individual insurance would decelerate, and -- the whopper -- average premiums would decline dramatically, even for ACA-compliant plans.
By 2024, in fact, premiums for Obamacare plans would be lowered 37%-55% relative to leaving the ACA intact. (Exactly how the parallel availability of stripped-down plans under Consumer Freedom would work this magic on ACA-compliant policies was not addressed.)
But here's the rub: the HHS analysis did not consider the proposal as an amendment to the BCRA -- which would also have ended Medicaid expansion and dramatically scaled back the ACA's private insurance subsidies. Rather, it treated it as an amendment to the ACA, leaving intact all its provisions except those banning the limited coverage plans that Cruz wants to permit. (And by the way, the HHS analysis assumed that those Consumer Freedom plans would come with $12,000 deductibles.)
Did Cruz really mean to offer his proposal as an Obamacare fix? It's hard to say -- his statement reiterated his longstanding commitment to repealing "the disaster that is Obamacare." But in the same breath he backed an impact study predicated on retaining large segments of the ACA.
Go figure.