The presence of a mandate is where the similarities between the ACA and the Heritage Plan end, and the massive remaining differences reveal the disagreement between Democrats and Republicans about the importance of access to healthcare for the nonaffluent. The ACA substantially tightens regulations on the healthcare industry and requires that plans provide medical service while limiting out-of-pocket expenses. The Heritage Plan mandated only catastrophic plans that wouldn’t cover basic medical treatment and would still entail huge expenditures for people afflicted by a medical emergency. The Affordable Care Act contained a historic expansion of Medicaid that will extend medical coverage to millions (and would have covered much more were it not for the Supreme Court), while the Heritage Plan would have diminished the federal role in Medicaid. The ACA preserves Medicare; the Heritage Plan, like the Paul Ryan plan favored by House Republicans, would have destroyed Medicare by replacing it with a voucher system…
[T]he argument that the ACA is the “Heritage Plan” is not only wrong but deeply pernicious. It understates the extent to which the ACA extends access to medical care, including through single-payer insurance where it’s politically viable. And it gives Republicans far, far too much credit. The Republican offer to the uninsured isn’t anything like the ACA. It’s “nothing.” And the Republican offer to Medicare and Medicaid recipients is to deny many of them access to healthcare that they now receive. Progressive frustration with the ACA is understandable, but let’s not pretend that anything about the law reflects the priorities of actually existing American conservatives.
No, Obamacare Wasn’t a “Republican” Proposal