What Ryancare and Obamacare Have in Common

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"It's really peculiar to come along and say you want to repeal the Affordable Care Act exchanges but create exchanges for the elderly," Brookings health care expert Hank Aaron tells Ezra Klein in this interview on Paul Ryan's Medicare plan.

It is peculiar. The more I think about it, the most peculiar thing about Paul Ryan's Medicare plan is his insistence to repeal the delivery system reforms within the Affordable Care Act right away and immediately pass a law that phases in Medicare reforms starting ... in 10 years. It's also peculiar, because in 10 years, the ACA begins to implement changes that look like a softer version of Ryan's plan.

This is, I think, one of the most underappreciated and undersold assets of the ACA. The architects of the ACA scheduled subsidies for the low-income to slow into the 2020s, just as the excise tax eats into employer health care premiums within the upper-middle class. As families across the country are more exposed to health care costs, they'll join the exchanges to buy cheaper insurance plans. This way, the health care overhaul is explicitly designed to move us from an employer-based system with huge subsidies to an exchange-based system with smaller subsidies. And this is all scheduled to happen in the same decade Ryan's voucher system would come online.

Read the full interview at Ezra Klein's blog.

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Derek Thompson is a senior editor at The Atlantic, where he writes about economics, labor markets, and the entertainment business.

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