Says Scott Walker's plan to replace Obamacare "is a new entitlement" program for "every single American human being from the time they are born right up until they grow old and become eligible for Medicare."
The day Wisconsin Gov. Scott Walker unveiled his proposal to replace Obamacare, one of his rivals for the GOP presidential nomination jumped all over him. No, it wasn't Donald Trump. The attack came from Bobby Jindal, who has trailed Trump, Walker and other Republicans in presidential preference polls. In a nine-paragraph statement issued Aug. 18, 2015, the Louisiana governor called Walker's proposal an entitlement program -- seven times. A featured punch line: "In Governor Walker’s plan, a new entitlement is created for every single American human being from the time they are born right up until they grow old and become eligible for Medicare." So, is Walker proposing what amounts to a new entitlement program -- and for every American human being? Setting the table Let's set out a couple of markers before we dig in. 1. Walker's 14-page proposal is essentially in outline form. It is a political document rather than a formal program. The Christian Science Monitor -- noting that health care expert Avik Roy estimated Walker’s proposal would cost about $1.1 trillion over 10 years -- observed that the plan "devotes only two sentences to outlining how this might be paid for." (Obamacare is expected to cost $1.2 trillion, according to a March 2015 estimate by the nonpartisan Congressional Budget Office.) 2. There is some subjectivity in the term entitlement; it doesn't have a legal definition. At the same time, what constitutes an entitlement is well-established at the federal level. Defining entitlement A federal entitlement program gives benefits to everyone who qualifies -- without regard to how much, in total, the benefits will cost the government. That is, for most government programs, spending is limited to the amount that has been appropriated by Congress. But for entitlements, there is no predetermined limit -- the government spends whatever is necessary to provide the promised benefits to every eligible person who claims them. More formally, "A Glossary of Political Economy Terms" by Auburn University political scientist Paul Johnson, says an entitlement program "provides individuals with personal financial benefits to which an indefinite number of potential beneficiaries have a legal right whenever they meet eligibility conditions" specified by the law that authorizes the program. The glossary lists Social Security, Medicare and Medicaid -- as well as most Veterans' Administration programs, unemployment compensation and food stamps -- as being among the most important federal entitlements. Obamacare's entitlement Tax credits are one benefit offered under Obamacare. They are an entitlement, Harvard University economist and health care expert David Cutler told us. Anyone with moderate income who isn't eligible for coverage through an employer can get the subsidies, which are used toward the cost of buying insurance from the health insurance marketplace. The amounts vary depending on an individual's or family's income, as well as where they live. Place of residence helps take into account how the cost of coverage can vary by region. Walker's plan Walker’s proposal, called "The Day One Patient Freedom Plan," doesn’t use the word entitlement, of course. But Walker also would provide tax credits to people who do not have employer-based coverage, saying they would make health insurance more affordable and more portable. Those credits are what Jindal highlighted in his statement. Walker's credits differ from Obama's in that the amounts would be based only on age, not income or other factors. The plan says that, for example, a 35-year-old woman who makes $35,000 per year and has no children now gets nothing in Obamacare subsidies "because she’s too young and too middle class." But under Walker’s plan, she would get a $2,100 tax credit "that she could use to shop for insurance in the open market and put any savings into a health savings account." Several experts, from across the political spectrum, agreed that Walker's credits are an entitlement. Roy, in a blog post published in the conservative National Review the day after Walker's plan was released, used that word explicitly. "The core of Walker’s approach is a new, universal entitlement that every legal U.S. resident would be eligible for, regardless of income or need," wrote Roy, who is a senior fellow at the Manhattan Institute, a conservative New York think tank, and the opinion editor at Forbes. Economist Henry Aaron, a health care expert at the Brookings Institution think tank in Washington, D.C., told us that compared to Obamacare, Walker's plan would cost less and provide lesser benefits. But both sets of credits are are entitlements, he said. And Robert Kraig, executive director of the liberal Citizen Action of Wisconsin, said Walker’s program would be a broader entitlement than Obamacare because the tax credits would be available regardless of income to anyone up to age 65 who does not have employer-based health coverage. Still, Jindal's claim goes too far. Michael Tanner, a health care expert at the libertarian Cato Institute in Washington, agreed that Walker's tax credits are an entitlement. But he pointed out that they aren't necessarily new, since they're essentially the same, if smaller, than credits provided by the Affordable Care Act. Moreover, Jindal claims everyone would get Walker’s entitlement, when it would only apply to people who don’t get health insurance from their employer. Walker's campaign initially didn't address Jindal's claim, instead sending us articles in which conservatives praised the plan. But in a follow-up email, campaign spokeswoman Stacy Day said defining an entitlement as a financial benefit that everyone who qualifies for would get, without regard to the total cost of the government, is too broad. "Take a deduction approach, as some support," she wrote, "Under the definition you offered, any individual who qualifies for his health insurance deduction would receive the deduction without regard to the total cost to the government -- in this case, a reduction in the government's tax revenues. Moreover, there is no set appropriation for a deduction, the total amount spent would be determined by how many people are eligible for the deduction. Under this unreasonably broad definition of entitlement, all tax preferences would be entitlements. This is just not correct." That belies the example provided in Walker's own plan, where a person, regardless of income or other factors, would receive $2,100 in tax credits. As well as a consensus among the experts we spoke with that, like the Obamacare tax credits, Walker's credits are an entitlement. Our rating Jindal said Walker's plan to replace Obamacare "is a new entitlement" program for "every single American human being from the time they are born right up until they grow old and become eligible for Medicare." Walker’s proposal includes tax credits to help people buy coverage in the private market. The credits would be available to everyone up to age 65 -- without regard to income or other requirements -- but only if they don’t get health insurance from their employer. The credits aren't entirely new, however, as they are similar to those provided under Obamacare. For a statement that is partially accurate, our rating is Half True.
['United_States', 'Medicare_(United_States)', 'Patient_Protection_and_Affordable_Care_Act']