Reply #25: You should really look at it through two entirely different lenses: the reform, and the amounts. [View All]

If we were to compare the affordable care act (2014 and beyond) to Ryan's plan in terms of the reform (i.e. exchanges, mandated benefits packages, community rating and guaranteed issue, medical loss ratios, other insurance regulation, etc), the affordable care act is MUCH, MUCH better than Ryan's plan. They don't even compare.

If we were to instead simply compare the subsidy amounts, of course Ryan's plan would be better (at least in the initial years). But this is hardly a surprise -- before the affordable care act, we had an 80-100% subsidy for healthcare for those over 65 (Medicare), and a 0-25% subsidy for healthcare for the non-poor under 65 (the employer healthcare tax credit).

So even a large increase in the subsidy for those under 65 (the affordable care act) is still going to be lower than a large decrease in the subsidy for those over 65 (Ryancare). But that doesn't mean the affordable care act isn't worth enacting, or that Ryancare is worth enacting -- it simply reflects the state of both healthcare systems before anything was enacted. The affordable care act is a significant improvement over the pre-status-quo.