J.D. Vance returns to hated 'death spiral' health plan dropped by GOP years ago: columnist

Donald Trump's "concept of a plan" to replace Obamacare, as later elaborated on by running mate Sen. J.D. Vance, echoes "horribly unpopular" policy inspired by Republican's baseless fear of a health care "death spiral," a new analysis shows.

The Intelligencer's Jonathan Chait on Tuesday delved into the questionable health care policy Vance (R-OH) presented Sunday on NBC's "Meet the Press" to explain away his running mate's much-mockeddebate night gaffe, in which he said he had just a "concept of plan" when asked about if he would replace Obamacare.

"What Vance came up with is not only surprising," Chait wrote, "but, if I understand properly, far more damaging than Trump’s original statement."

In his interview, Vance made the case for deregulating the insurance market to trigger lower costs for younger and healthier policy holders.

Chait notes this idea isn't new, but dates back to a plan Republicans pitched then abandoned after the Affordable Care Act passed in 2014.

"Republicans don’t talk about this idea much any more," Chait wrote. "The basis for it (the Obamacare death spiral) has failed to occur and because letting insurance companies discriminate against people with preexisting conditions is horribly unpopular."

To help readers understand the theory, Chait provides a brief healthcare history.

Before Obamacare, Americans not receiving health care coverage from a federal program or an employer were dependent on individual insurance providers obligated to weed out the sick — or refuse them coverage — in order to turn a profit, Chait reported.

"Obamacare turned that dysfunctional individual market into a market that offered affordable plans even for people who aren’t young and healthy," Chait wrote. "It prevented insurers from screening out customers with a preexisting condition or denying coverage for necessary procedures."

To recuperate the profit loss Obamacare regulations triggered, insurance providers raised costs for younger and healthier policy holders, as Republicans at the time predicted they would.

But Republicans also warned of an Obamacare “death spiral" in which insurers would keep raising rates as they kept losing customers unwilling to pay more.

This never happened, Chait reported, "But at the time, Republicans fervently believed the death spiral would happen ... and they devised a plan."

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For Chait, this plan bears striking similarity to Vance's explanation of Trump's "concept of a plan" in which he argued "deregulating the insurance markets" would allow Americans to "choose a plan that actually makes sense."

Chait acknowledged Vance's implied point that young people would pay less if placed in an exclusively low-risk insurance pool, but argued the Ohio senator left out a key point.

"What he doesn’t tell the audience is that allowing insurers to give cheaper plans to the young and healthy means letting them charge more — much, much more — to people who aren’t young and healthy," Chait wrote.

Should those people prove unable to pay, Chait concluded, "Trump’s concept of a plan would take access to medical care away from millions of Americans."