Questions For Paul Ryan About The Patients’ Choice Act

Rep. Paul Ryan (R-WI) released a new Republican health care plan (The Patients’ Choice Act) that’s fraught with questions and contradictions.

We pose the following queries:

Are the State Health Insurance Exchanges voluntary? The two-page summary notes that “The Patient’s Choice Act of 2009 would encourage states to establish rational and reasonable consumer protections.” The more detailed summary says, “The Patients’ Choice Act would ensure that the federal government partners with states to create State Health Insurance Exchanges.”

Is the GOP embracing European-style health care boards? To control premiums the report suggests “a model that works in several European countries.” The “independent board” would “penalize insurance companies that cherry pick healthy patients while rewarding companies that seek patients with pre-existing conditions.” How would this ensure affordability?


Are the tax credits adequate? The tax credit for families is $5,700, far below the average $12,300 that families are paying today. More importantly, how will the tax credits grow over time? Will they keep up with skyrocketing health care costs?

What happens to the individual health insurance market? The plan establishes State Health Insurance Exchanges outside of the existing individual market. How will the individual market be regulated? Will insurers be able to offer standard benefit packages within the State Health Insurance Exchange and more porous policies in the individual market?