Goldman Explains What The Repeal Of Obamacare Really Means

Tyler Durden's picture

After months of internal discord, House Republicans finally approved a bill to overhaul Obamacare, which they have been attacking since it was enacted in 2010.  While there are various nuances, here are the bill's main provisions courtesy of Reuters:


  • The Republican plan would maintain some of Obamacare's most popular provisions. It would allow young adults to stay on their parents' health plan until age 26.
  • The bill would let states opt out of Obamacare's mandate that insurers charge the same rates on sick and healthy people. It would also allow states to opt out of Obamacare's requirement that insurers cover 10 essential health benefits, such as maternity care and prescription drug costs.
  • The measure would provide states with $100 billion, largely to fund high-risk pools to provide insurance to the sickest patients. The bill also would provide $8 billion over five years to help those with pre-existing conditions pay for insurance.
  • It would let insurers mark up premiums by 30 percent for those who have a lapse in insurance coverage of about two months or more. Insurers won a provision they had long sought: The ability to charge older Americans up to five times more than young people. Under Obamacare, they could only charge up to three times more.


  • The bill would end in 2018 Obamacare's income-based tax credits that help low-income people buy insurance. These would be replaced with age-based tax credits ranging from $2,000 to $4,000 per year that would be capped at upper-income levels. While Obamacare's credits gave more help to those with lower incomes, the Republican plan would be largely age-based.
  • The Republican bill would abolish most Obamacare taxes, including on medical devices, health insurance premiums, indoor tanning salons, prescription medications and high-cost employer-provided insurance known as "Cadillac" plans.
  • Those taxes paid for Obamacare. Republicans have not said how they would pay for the parts of the law they want to keep.
  • The bill would also repeal the Obamacare financial penalty for the 2016 tax year for not purchasing insurance, as well as a surtax on investment income earned by upper-income Americans.
    It would repeal the mandate that larger employers must offer insurance to their employees.


  • Under Obamacare, more than 30 states, including about a dozen Republican states, expanded the Medicaid government health insurance program for the poor. About half of Obamacare enrollees obtained insurance through the expansion.
  • The bill would allow the Medicaid expansion to continue until Jan. 1, 2020. After that date, expansion would end and Medicaid funding would be capped on a per-person basis.
  • State Medicaid plans would no longer have to cover some Obamacare-mandated essential health benefits, fulfilling a Republican promise to return more control to the states

* * *

And while all of the above works in theory, there remains a rather sizable gap between the theory and practice. So for all those curious what yesterday's bill passage means in practical terms, here is Goldman's Alec Philips with the explanation:

House Passes AHCA BOTTOM LINE: The House has passed its health legislation but the issue is unlikely to be resolved for several more months, if at all.


The main effect of House passage is to delay the consideration of tax legislation, which looks even more likely than before to be delayed until 2018.




1. The House passed its ACA replacement bill, the American Health Care Act (AHCA) 217-213, which moves the debate to the Senate. However, Republicans in that chamber are unlikely to support the House bill in sufficient numbers, likely requiring substantial changes to the bill. In addition, procedural hurdles exist that could require several aspects of the House-passed bill to be stripped (including those that relate to the recent political compromises used to bring hesitant lawmakers onboard). It is far from clear at this point whether the Senate will be able to pass its own version of the AHCA at all, and at a minimum it is likely to take months to do so.


2. In our view House passage of the AHCA is likely to further delay the consideration of tax reform. House passage arguably reduces doubts that Republicans can assemble a working majority for controversial legislation in the House, which suggests that complex tax legislation might be achievable as well. However, since the House cannot act on tax reform using the “reconciliation” process until the Senate has passed (or decides not to pass) its own health legislation, tax legislation looks unlikely to emerge until September in our view. Given the time it will likely take to reach an agreement on tax legislation, this suggests that enactment of tax legislation is unlikely until Q1 2018. While our base case is still that legislation is more likely than not to pass in 2018, further delays could push consideration of tax legislation too close to the upcoming midterm election, reducing the likelihood that tax legislation is enacted in the next two years.

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nmewn's picture

Not even close. 

A few moar Pyrrhic victories like this and all our freedom of choices will be lost. 

Mother Of All Bomb's picture

I'm making over $7k a month working part time. I kept hearing other people tell me how much money they can make online so I decided to look into it. Well, it was all true and has totally changed my life. This is what I do...

Fizzy Head's picture

So the pubs have been threatening repeal for the last 6 years and they have the majority and here we are, with an "overhaul"??

Wtf? I have zero faith in any politician.

FrozenGoodz's picture

I pray no Trump supporters here have pre-existing conditions ... or a dad who's diabetic ... or get a girl preggers


Risk pool kinda sounds like something in O'riely/Sheen backyards

nmewn's picture

If a prog like you is for this assault on individual choice it removes any doubt that it's not a POS.

new game's picture

dead pool, swim at your own risk...

new game's picture

i'm saving over 700/month by not having healthcare.

not to mention copays, deductables and no lube procedures...

Siamo pazzi's picture

Nice! I love working for me .. I moved and my clientele hard to replace ...
Was there any up front cost to startingvyour new p/t biz?

swmnguy's picture

Depends on what you mean by "cost."  He had to give up his self-respect, but for some people that's not much of a loss.

new game's picture

The bill would also repeal the Obamacare financial penalty for the 2016 tax year for not purchasing insurance.   AWESOME, REALLY GREAT IDEA. SOME REALLY AWESOME PEOPLE ARE WORK VERY VERY HARD TO BRING AFFORDABLE HEATHCARE AMERICANS. (lol)

I'm all in on this one. opt out and paygo negotiated by me myself and the seller of overcost heath care.

or leave the country for certain procedures.

remember, we have options as they try to captivate us in their sickcare scheme...

silverer's picture

I remember reading how people got an "exemption" for having to pay the penalty. Well, for many inner city deadbeats it was almost automatic. If you didn't pay your utility bill two months in a row you would be exempted from paying the Obamacare penalty. I'll bet that caught on really quick. I'm also thinking they don't shut your power off until a little bit past that, so they weren't even inconvenienced. Just skip two months, then catch up with the bill.

new game's picture

do not worry about an irs audit. there are exemptions such as religous or simply could not afford the cost of premiums. it is there. fear, your worst enemy and robber of the wallet.

Fizzy Head's picture

ok so the 2016 tax year has come and gone... so what about 2017 and beyond?

Paul Kersey's picture

How to bring dwon healthcare costs:

1. Cut out the middlemen (healthcare insurance companies)

2. Slash the cost of prescription drugs with international competition (U.S drug companies are already manufacturing drugs in Ireland, and still keep drug prices high).

3. Mandate that the obese, the smokers and the alcohol and drug abusers pay more so that everyone else can pay less. Folks who who ignore the laws of cause and effect should pay some kind of penalty fee.

Stinkytofu's picture

but then who gets to pick and choose which nasty/naughty habits/vices have to pay more?

will it be like in california?


where you can discriminate against smokers of tobacco, but you

may NOT, on pain of death, discriminate against smokers of sausage.


how 'bout making the butt-pirates pay up for hiv treatment costs?

oh, no!  cause sticking your penis in another man's rectum is a human

right!  it's in the constituition!

nmewn's picture

You just can't stop yourself from allowing. gov to dictate how people live, can you? 

truthseeker69's picture

Trump is the useful idiot Obama needed to rebrand Obamacare to Trumpcare.


/69-D CHESS/ 

MalteseFalcon's picture

If .gov doesn't dictate to you, the insurance companies will.

Or you can go without insurance completely.

That will last until you have the inevitable serious medical problem.

Freedom is great, but responsibility is the other side of the coin.

Look around.

Can everybody handle freedom or responsibility?

nmewn's picture

The choice should be for the individual to make. 

The insurance companies can't screw with you if you don't interact with them and .gov shouldn't be forcing you to interact with them. As far as "inevitable medical needs" that's for each of us to decide.

Its inevitable I'm going to die but it could be from a massive heart attack or some thug getting the drop on me or these idiots who don't know how to drive...there is no need for medical insurance or "health care" under those circumstances. 

Everybody accepting the socialist premise that health insurance is a right in no way obligates me to participate in the crime and AGAIN you are not supposed to be COMPELLED to exercise a right, a right is also a choice of when you choose to exercise it.

Further, a right doesn't require a special payment to .gov or an insurance company. 

new game's picture

most logical people would call that a physical with blood tests incl. hep c, a colestral check and body fat mass.

the outcome would determine cost of healthcare premium.

but we must get votes to keep the power at reellection time.

plus insurers are lobbying the outcome.

plus existing laws have conditioned people to believe it is a basic right.

damn the prexisting condition, i deserve to be a selfrightous merican with no implied self determination that goes with self discipline, exercise and healthy diet.

deep state financial arm will continue what AHCA started; that is a given.

truely is hopeless once i get past my cog dis of wish/hope crap.

how long does the human condition allow one to see the same outcome and STILL BELIEVE it will be different this tyme? lol to a great day of not read9ing this shit anymore. have a good one...

MalteseFalcon's picture

Everybody gives a blood sample every year.

What is tested for and who is informed?

Right now "they" can (and as need be, do) learn all kinds of intimate things about patients and the patients have "volunteered".

We got privacy laws?

The land of the lawless has lots of laws.

RiverRoad's picture

The ball-less wonder Senate will only act when Obamacare blows up in their face as Trump well knows.  The House had nothing to lose by passing it.

Silver Bug's picture

Nobody should believe anything the highly corrupt Goldman sachs states. They have openly admitted to lying to their clients on a regular basis, they are only out to gouge their clients. The time is coming when the masses wake up.

Ouagadoudou's picture

Talk about crony capitalism ....

nmewn's picture

I've never trusted them...they are statists and their only true interest is in growing their power and the peoples dependency on the federal government. Read the below carefully, at the end of the day they all want single payer.

Meaning government, they want to levy a tax on everyone in order their infinite wisdom..."redistribute"...those monies more evenly. 

  • "It would let insurers mark up premiums by 30 percent for those who have a lapse in insurance coverage of about two months or more. (Edit: That is still a mandate to have insurance coverage at all times.) Insurers won a provision they had long sought: The ability to charge older Americans up to five times more than young people. Under Obamacare, they could only charge up to three times more. (Edit: That is to insure its DOA in the Senate, the AARP will come unhinged and SCOTUS will rule it is blatant age discrimination.)"
Kefeer's picture

Reminds me of the "voluntary tax system" we have until you ddon't pay the taxes.  These peole have no capacity to speak truth; only lies.

nmewn's picture

lol...part of the joy of living (for me, to 57yrs old) is we get to look back at the ABSOLUTE MAELSTROM OF LIES that we pointed out & argued with progs & statists about our entire lives and now being proven correct.

The "voluntary tax system" is another example of just that. To go along with the the fact that the mainstream legacy media is, by & large infested, top-to-bottom with statist, leftist, Alinskyite commie pricks.

There is no argument about it being composed of "open minded objective journalists" anymore either ;-)

Dogman57's picture

Again, where in the U.S. Constitution is "health care".  I can't find it. 

nmewn's picture

Its right next to the word democracy...which is also not in there.

monoloco's picture

It's right in there with the part about how we are required to be the world's policemen.

DEMIZEN's picture

there is nothing in for me.

FrozenGoodz's picture

Did you send the check to the correct white male in the house?


Made out to P. Ryan?

DEMIZEN's picture

next time ill send check for 1.50 to P.Rino and vote for"legal marijuana and free pussy now party"

Megaton Jim's picture

The biggest problem is all the scammers that are gaming the system. Not to mention the (((REAL THIEVES))) working the system!

overmedicatedundersexed's picture

maybe you nay sayers should look at this:  winning

"The American Health Care Act (HR 1628) passed by the House today reduces taxes on the American people by over $1 trillion. The bill abolishes the following taxes imposed by Obama and the Democrat party in 2010 as part of Obamacare:

-Abolishes the Obamacare Individual Mandate Tax which hits 8 million Americans each year.

-Abolishes the Obamacare Employer Mandate Tax. Together with repeal of the Individual Mandate Tax repeal this is a $270 billion tax cut.

-Abolishes Obamacare’s Medicine Cabinet Tax which hits 20 million Americans with Health Savings Accounts and 30 million Americans with Flexible Spending Accounts. This is a $6 billion tax cut.

-Abolishes Obamacare’s Flexible Spending Account tax on 30 million Americans. This is a $20 billion tax cut.

-Abolishes Obamacare’s Chronic Care Tax on 10 million Americans with high out of pocket medical expenses. This is a $126 billion tax cut.

-Abolishes Obamacare’s HSA withdrawal tax. This is a $100 million tax cut.

-Abolishes Obamacare’s 10% excise tax on small businesses with indoor tanning services. This is a $600 million tax cut.

-Abolishes the Obamacare health insurance tax. This is a $145 billion tax cut.

-Abolishes the Obamacare 3.8% surtax on investment income. This is a $172 billion tax cut.

-Abolishes the Obamacare medical device tax. This is a $20 billion tax cut.

-Abolishes the Obamacare tax on prescription medicine. This is a $28 billion tax cut.

-Abolishes the Obamacare tax on retiree prescription drug coverage. This is a $2 billion tax cut.

As a presidential candidate in 2008, Barack Obama had promised repeatedly that he would not raise any tax on any American earning less than $250,000 per year. He broke the promise when he signed Obamacare. With the passage of the House GOP bill, tens of millions of middle income Americans will get tax relief from Obamacare's long list of tax hikes."

youarelost's picture

it does nothing as it was not signed. 

Kefeer's picture

It is already dead in the Senate and so this was a short-lived jackass and elephant show.

DEMIZEN's picture

so i get the 1 billion tax cut? who gets the tax cuts? how these numbers reflect my tax bill?  

how do i benefit from these tax cuts  if my family insurance and out of pocked tijuana medical expenses goes up for 400 a month due this new bill and get like 400 bucks tax break at the end of the year? your breakup is nice and i appreciated but it doesnt really imply that I or any other indivial is going to benefit from this bill,  80% of this tax cut will benefit  MIC or some other evil doers.

if money dissapears in the swamp one or another way  id rather see someone with a new dental brace or whatever. If the tax abolished does not directly and in full sum benefit the people who lost the benefits due to tax savings than i dont give a fuck for your savings. this is not an improvement. it is a wealth transfer.

overmedicatedundersexed's picture

well only here 26 weeks, so we can forgive your lack of understanding..reducing .gov income has it's own your case a better national need to bring yourself up to speed on taxes ..they are a boot on the neck of families and business..if you cannot see the benefits of this tax should start reading the threads of prior years of ZH..good luck to you

DEMIZEN's picture

reducing .gov income has it's own your case a better national economy


 reduce it to zero, do not stop halfway. I am all for it.

new game's picture

cutting will take a revolution with blood, guts and maybe glory. there is no other way with the deep state firmly in complete control of police state, the finances andthe  propaganda arm.

how is that last election working out? lol.

democracy my fuking ass...


DEMIZEN's picture

i was trying to make a point about how much of .gov is the right amount of .gov. It depends on individual taxpayer. lower taxes do not translate to economic growth without transparent spending and clearly visible beneficaries who then cycle the profits back into economy. i dont take IOUs or promises of future growth based on obsolete dogma. I want the tax cut now.  while more money in other peoples pockets may not be bad, more money in my pocket is the best for the economic growth and jobs.  dispute that!

chaos is a bitch. but so is tyrany. 

pparalegal's picture

All that is meaningless Starbucks conversation fodder until there is a law. Live long and prosper. Until you turn "unproductive" GMO'd worker tax cow at 50.  Like George Carlin said: it is not for you, the bankers (and their politician concubines) want your savings accounts, 401(k)'s and retirement fund money back before you can use it.  Suckas.

redtie's picture


Won't pass.,Special interest groups.,Love of money... all working against passage of this bill in senate. 

Pickleton's picture

"With the passage of the House GOP bill, tens of millions of middle income Americans will get tax relief "

Maybe you should snap back to reality.  It's all going to be replaced with new and improved taxes, courtesy of the GOP: Losing.



The record will reflect the Const finally succummed, ath the hands of the "limited govt conservatives" yesterday.

sister tika's picture

It is reassuring that both the House and the Senate have (or will) legally exclude themselves (again) from another version of the Common Peasant Health Care Act (CPHCA).

The American Health Care Act (AHCA) appears to be better than the ACA, but the "odds" of it getting past the Senate as currently written are slim to none.

Siamo pazzi's picture

Nothing legal about it . They are a rogue foreign 10 sq miles . Pirates . Flying our flag . Kick them out . That's the solution . Our forefathers would not hesitate .

sister tika's picture

These rogue pirates should be cordially invited to "walk the plank".