During Paul Ryan’s health-care “TED talk” on Thursday, in which the House speaker attempted to sell the public on the GOP Obamacare replacement plan through Powerpoint slides, there was one moment that prompted many a double-take on Twitter.
“The idea of Obamacare is … that the people who are healthy pay for the people who are sick,” Ryan said. “It’s not working, and that’s why it’s in a death spiral.”
There are a few reasons the statement sparked confusion:
First, most would argue Obamacare is not in a death spiral.
Second, the payment model Ryan described—cross-subsidization between healthy and sick people— is how almost all insurance schemes work, as was pointed out repeatedly by health wonks on Thursday afternoon:
Paul Ryan says insurance can’t work if healthy must pay more to subsidize the sick. But this is exactly what happens in every employer plan.— Jonathan Cohn (@CitizenCohn) March 9, 2017
Ryan represents the “sick” people in his model with a small red triangle that looks to be about an eighth of the population. He calls them “people with pre-existing conditions.” But, according to the Kaiser Family Foundation, more than a quarter of Americans have pre-existing conditions that would make them uninsurable. So the red triangle either should be much larger, or it doesn’t represent what Ryan says it does.