- The Affordable Care Act, also known as Obamacare, has been a contentious issue for Republicans
- Republicans now have the opportunity to potentially repeal Obamacare with control of the White House and Congress
- Some constituents at town halls are furious about the possibility of Obamacare being taken away
- Obamacare was implemented to solve problems such as denial of coverage due to pre-existing conditions and lack of coverage for millions of Americans
- However, the law has flaws, including high deductibles and increased premiums
- Republicans have complained about the flaws but have not taken responsibility for fixing them
- Republicans now need to present a replacement plan for Obamacare, but so far, there is little information on what that plan will be.

- The video discusses the Republican plans for healthcare and highlights some key points
- Republicans are proposing refundable tax credits for people to buy affordable coverage, but these credits would be based on age rather than income, potentially benefiting wealthy individuals more
- Health savings accounts (HSAs) are also being promoted, but they may not be effective for those who are too poor to save or who have high healthcare costs
- Block grants are suggested to fund Medicaid, which could lead to a reduction in coverage for the poorest Americans
- High-risk pools are proposed as a way to cover people with pre-existing conditions, but they could be expensive and may not be properly funded
- The individual mandate, a requirement to have insurance, is not included in the Republican plans, which could lead to fewer people being covered
- The video criticizes the lack of a comprehensive plan and the potential negative consequences of the proposed changes.

Congressional Republicans could soon vote to repeal Obamacare.
John Oliver explores why their replacement plans are similar to a thong.

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-♪ ♪ -♪ ♪ The Affordable Care Act, also known as Obamacare, or in emails from your uncle as, Forward, Forward, Forward, the Communist Takeover of American Values.

For years now, Obamacare has been the bane of Republicans' existence.

If Obamacare is ever implemented and enforced, we will never recover from it.

This bill is an affront on the moral, morality of the provision of American health care.

Obamacare is the worst piece of legislation ever.

Yes, the worst piece of legislation ever.

So, good news, Fugitive Slave Act, you're finally off the hook.

But now, with Republicans controlling both the White House and Congress, they've gone from talking about repealing Obamacare to potentially being able to do it.

Already, the House and Senate have passed budget resolutions to start the process, and at least 1 member is positively giddy about it.

A little over 6 years ago, I lived in a pretty decent house.

And before I knew it, my colleagues from the other side of the aisle had let a goat loose in my house.

Now, for 6 years, that goat has been messing in and destroying my house.

I want to renovate my house, but before I can, I have to get the goat out of the house before it does any more damage?

It makes no sense to start fixing up my house until we get the goat out.

Voting for the fiscal year 17 budget resolution gets this goat out of my house.

There is just no way that goat incident didn't actually happen.

Speaker, nafta is like when you're half asleep 1 morning, you put your arm around what you think is your wife, but lo and

And you wonder, why is it wearing my wife's perfume?

And yet, all week long, Republicans have been dealing with an unexpected problem.

Constituents at town halls, furious that Obamacare might be taken away.

I could tell you 3 members of my family, including me, that would be dead, dead, and homeless if it was not for ACA.

♪ Yes, apparently, that annoying Obamacare goat in the house turned out to be a licensed physician who's been saving lives.

And a lot of people do not want her to go anywhere.

Oh, I'm sorry, you assumed that goat doctor was a man?

And look, that tone is actually a big shift.

remember, 8 years ago, people were absolutely terrified about what Obamacare might mean.

This is the stepping stone for a takeover by communism like Hitler did in Germany.

President Obama did not want to kill that guy's grandparents.

He'd have just ordered a drone strike and then declared them enemy combatants.

What it does, what needs fixing, and how Republicans plan to replace it.

And before we start, it's worth remembering just how bad things were before it was passed.

Nearly 49 million Americans had no coverage.

And if you were buying for yourself, insurers could deny anyone they considered too risky.

Some denied entire professions, like air traffic controllers, taxi cab drivers, and scuba divers.

And this baby was denied coverage at just 4 months old for an unexpected pre-existing condition.

His parents decided to apply for individual health coverage for Alex.

Not because of his age, but because he was too fat.

Look, yes, I understand that you're upset, but think about it.

He's never gonna lose the weight with that attitude.

But the point here is, Obamacare was an attempt to solve those problems.

It made it illegal to deny people coverage because of pre-existing conditions.

It let people stay on their parents' plans until age 26.

It made preventive screenings free for everyone and created marketplaces where people could shop for insurance with potential subsidies.

And between all that and Medicaid expansion, more than 20 million people gained coverage, putting our uninsured rate at a historic low.

for many people, like this woman, whose treatment

for breast cancer was covered under Obamacare, the law was just always too closely associated with the man responsible for it.

I absolutely detest hearing the words, -"Obamacare." --Yeah.

Okay, well, to be clear, it did have a proper name.

It was the Patient Protection and Affordable Care Act, but that does go to show you, it matters what people call something.

Would Emma Stone be as popular if her real name was Blump Sharts Cracker?

That's why it's good that she changed it.

early accusations held against Obamacare still linger.

Just this month, a Republican official, Bill Akins in Florida, threw out this classic at a town hall.

Here's the problems I have with the Affordable Healthcare Act.

Number 1, There's a provision in there that anyone over the age of 74 has to go before what is effectively a death panel.

Who here has read the Affordable Health Care Plan?

The notion of death panels isn't just a lie, it's PolitiFact's 2009 lie of the year.

Which is impressive considering that in 2009, America was also repeatedly told Jason Mraz was the next big thing.

The healthcare.gov website was broken on day 1, and the president famously made a very misleading promise.

If you like your doctor, you will be able to keep your doctor.

If you like your health care plan, you will be able to keep your health care plan.

Insurers drop policies and doctors change networks all the time.

That is as empty a promise as a father telling his daughter, I will always keep you safe, period.

Be honest and say, I'll try to keep you safe, but these bees are not fucking around.

And there have been practical problems, too.

Some plans have deductibles so high, they're essentially unusable, and in many places, premiums have increased sharply, and some insurers have dropped out.

Although, that was partly thanks to Republicans gutting a program in the original bill that helped protect insurers from unexpected losses.

And that has been something of a pattern here.

Republicans have happily complained about the flaws in the law, taken no responsibility for fixing them, and in fact have often undermined the whole thing.

It is their turn to present a plan, and the clock is ticking.

Insurance companies are deciding right now whether to even offer Obamacare plans next year.

But before you panic, there are ads on TV right now suggesting that Republicans have been working on something pretty special.

Health insurance that provides more choices and better care at lower costs.

House Republicans have a plan to get there without disrupting existing coverage, giving your family the health care it deserves.

Well, that sounds nice, but it is a little worrying that that ad is literally encouraging you to Imagine a better health care plan.

Now open your eyes and tell us what you came up with, because we've got fucking nothing.

That ad ends with learnmoreatabetterhealthcareplan.com.

But if you go there, this is the entire website.

A single page with just 2 sentences of text and the fucking ad again.

And if you click on the ad, it'll send you back to the website and so on and so on and so on and so on, until you don't even want health care because you're begging for the sweet relief of death.

Every time you get near something resembling a Republican plan, it seems to just recede into the distance.

In January, Trump said he was working on 1, and that it was very much formulated down to the final strokes.

But watch what happened when Tom Price, his Secretary of Health and Human Services, was asked about it at his confirmation hearing.

President Trump said he's working with you on a replacement plan for the ACA, which is nearly finished and will be revealed after your confirmation.

It's funny because the president lies to us all the time with no repercussions.

I see what the joke we're laughing at is.

If you need any more proof of how unprepared Republicans are right now, let me show you 1 of the draft bills they circulated.

It is just 7 pages long, and it ends abruptly with the word, -"placeholder." -$PLACEHOLDER And 1 member of Congress actually tried to spin that as a positive.

This placeholder provides the clearest signal yet that we're working with patients and health care groups to draft language that balances important health status protections with necessary risk mitigation tools.

If your spouse gave you a birthday card that said, placeholder, that would not be a signal they're working on the best language to express their feelings for you.

It would signal they forgot your birthday because they're fucking Sharon from The Office, and deep down, I think you actually know that.

--LAUGHTER AND APPLAUSE --The best sense we currently have of what Republicans want to do is from previous plans from both Price and Paul Ryan, and from these talking points that Ryan gave out ahead of the Congressional recess.

You're gonna be hearing a few phrases from this a lot in the coming months.

So let's take a moment to understand what they actually mean.

And let's start with the big 1, which Ryan has been talking up a great deal.

What we believe is the right way to go, which is what our plan is, are refundable tax credits for people to go be able to buy affordable coverage.

Basically, free money to help pay your premiums, which is a little surprising coming from Paul Ryan, a man who probably tips waiters by writing on the check, find a job the market has deemed has more value.

But you should know, this document suggests tax credits would be based on age, not income.

Meaning theoretically, 61-year-old billionaire Bill Gates would get a bigger subsidy than a 27-year-old making minimum wage.

And Gates clearly does not need that money.

He'll just blow it on more $10 haircuts and orthopedic sweaters.

But the real risk here is subsidies ending up too small for those who need them the most.

Tom Price once proposed a credit of $1,200 to people aged 18 to 35, and $3,000 to people 50 and up, which is roughly a third of the cost of the most bare-bones plans on the market today.

A tax credit that small helps cover your health insurance the way a thong covers your dad's ass.

It doesn't, and there's something that is fundamentally wrong about that.

Now, the next big term in here is health savings accounts, or HSAs, tax-free accounts where you can save money to pay for health care costs.

In your experience, why do these savings accounts...

Because you're spending your own money as opposed to someone else's.

It's like when my daughter goes to the mall with my credit card, or when I go to the mall with my credit card, our purchases come back quite different.

Okay, setting aside that health care is nothing like shopping at the mall.

Shouldn't you come back with different purchases than your daughter, regardless of whose credit card you have?

If you came back from the mall with a tongue ring, a bottle of manic panic hair dye, and a Yas Queen crop top, it would raise a lot of questions having nothing to do with healthcare.

Now, the key problem with HSAs should be obvious here.

They're great for rich people, they're basically a tax shelter.

But if you're too poor to save, or you get sick enough to blow through what you've saved, you're not going to be covered, and you have that thong problem again.

Just listen to the reaction when Joni Ernst tried bringing them up at a town hall.

That is an appropriate reaction, when your problem is, I don't have enough money, and the proposed solution is, well, if you ever do, here's a very fancy piggy bank.

A phrase perfectly designed to bore you, because it combines block, the most nothing shape, with grant, your co-worker's nothing boyfriend.

♪ Paul Ryan wants to use block grants to fund Medicaid, which largely provides health care to the poorest Americans.

Basically, he wants to stop guaranteeing to pay each state a percentage of their Medicaid costs, and instead, just send them a fixed block of money.

But, if costs start to rise, and the block grant doesn't keep pace, guess what?

Thong for thong, thong, thong ♪ And You should know,

a few years ago, Ryan proposed a block grant program that a study estimated could kick as many as 20 and a half million people off Medicaid over a decade.

That's a kind of evil so chillingly banal, you just don't see it coming.

It's like if you found out that Grant was a serial killer.

I kill in plain sight, for none can remember my face.

to the final big talking point here, and I'll let Paul Ryan explain.

We believe that state high-risk pools are a smarter way of guaranteeing coverage for people with pre-existing conditions.

Now, they may sound like something you find at Jeremy Piven's house, but What they actually do is isolate the sickest people in their own insurance group.

Now, in theory, this brings everyone else's insurance rates down, but there is an obvious problem here again.

Those pools are going to be incredibly expensive, which is fine if the government subsidizes them properly, but if it doesn't, that's right.

Because 3 years ago, a study estimated that adequately funding high-risk pools just to maintain Obamacare levels of coverage would cost around $178 billion a year.

Imagine you asked for 178 pounds of grade A premium hunk, but instead of Chris Evans, someone brought you 6 of his severed toes.

Well, Tom Price's plan is 6 severed hunk toes.

So, those are the 4 big bullet points, but perhaps the most revealing thing about this document is not what's inside it, but what is not in there.

Because there is no replacement for the individual mandate.

Obamacare's requirement that you have insurance or pay a penalty.

And it is the thing that people hate the most.

The individual mandate is unconstitutional.

We gotta get rid of the individual mandate.

I believe that is a freedom-killing part of the Affordable Care Act.

Who's got 2 thumbs and hates the individual mandate?

-♪ Yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah ♪ But the mandate keeps younger, healthier people in the system, which is crucial to lower the cost for everyone else and to keep in popular provisions, like, among other things, not punishing fat babies.

The Republican solution is to make it really painful for you to get insurance again if you drop it at any point for any reason.

They use the positive sounding term, continuous coverage incentive.

But it has to involve some kind of penalty.

Maybe a higher premium or even denial of coverage.

And they are not keen to talk about details there.

That was in place of an explanation of the continuous coverage incentive.

Basically, this is a subject so toxic, they'd rather just go abruptly silent, much like when you're a white person singing karaoke and you realize, uh-oh, we have an N-word coming up.

And what Price and Ryan have given them so far seems to shift costs from the government to the people and from the healthy to the sick.

And fewer people are going to be covered.

Oh, and there's actually 1 more problem here, because you remember how much shit you gave President Obama for saying you can keep your doctor.

Let me remind you what Donald Trump has promised that you are going to do.

This is an un-Republican thing for me to say, because a lot of times they say, no, no, the lower 25 percent, they can't afford private.

I don't care if it costs me votes or not.

Everybody's gonna be taken care of much better than they're taken care of now.

The government's gonna pay for it, but we're gonna save so much money on the other side.

But for the most part, it's going to be a private plan, and people are going to be able to go out and negotiate great plans with lots of different competition, with lots of competitors, with great companies, and they can have their doctors, they can have their plans, they can have everything.

So, anything short of that is a disaster, and insurers are gonna need an answer soon, Republicans, so tick-tock, motherfuckers, because

you don't get to placeholder your way out of this 1 again.


Speaker 0: -♪ ♪ -♪ ♪ The Affordable Care Act, also known as Obamacare, or in emails from your uncle as, Forward, Forward, Forward, the Communist Takeover of American Values. For years now, Obamacare has been the bane of Republicans' existence.

Speaker 1: If Obamacare is ever implemented and enforced, we will never recover from it.

Speaker 2: This bill is an affront on the moral, morality of the provision of American health care. Obamacare is the worst piece of legislation ever.

Speaker 0: Yes, the worst piece of legislation ever. So, good news, Fugitive Slave Act, you're finally off the hook. But now, with Republicans controlling both the White House and Congress, they've gone from talking about repealing Obamacare to potentially being able to do it. Already, the House and Senate have passed budget resolutions to start the process, and at least 1 member is positively giddy about it.

Speaker 1: A little over 6 years ago, I lived in a pretty decent house. And 1 day, I heard a knock on the door. And before I knew it, my colleagues from the other side of the aisle had let a goat loose in my house. Now, for 6 years, that goat has been messing in and destroying my house. I want to renovate my house, but before I can, I have to get the goat out of the house before it does any more damage?

It makes no sense to start fixing up my house until we get the goat out. Voting for the fiscal year 17 budget resolution gets this goat out of my house.

Speaker 3: That is so specific.

Speaker 0: There is just no way that goat incident didn't actually happen. I bet he brings it up all the time. Mr. Speaker, nafta is like when you're half asleep 1 morning, you put your arm around what you think is your wife, but lo and

Speaker 3: behold, it's that goat again. And you wonder, why is it wearing my wife's perfume? Get this goat out of my house, y'all!

Speaker 0: And yet, all week long, Republicans have been dealing with an unexpected problem. Constituents at town halls, furious that Obamacare might be taken away.

Speaker 4: I could tell you 3 members of my family, including me, that would be dead, dead, and homeless if it was not for ACA. -♪ Yeah! ♪ -♪ Yeah!

Speaker 0: ♪ Yes, apparently, that annoying Obamacare goat in the house turned out to be a licensed physician who's been saving lives. And a lot of people do not want her to go anywhere. And yes, I said her. Oh, I'm sorry, you assumed that goat doctor was a man?

Speaker 3: What the fuck is wrong with you? Hashtag Lady Goats Can Be Doctors. Hashtag feminism. And look, that tone is actually a big shift. Because if you

Speaker 0: remember, 8 years ago, people were absolutely terrified about what Obamacare might mean.

Speaker 5: This is the stepping stone for a takeover by communism like Hitler did in Germany.

Speaker 6: Obama's a Marxist socialist.

Speaker 3: No! Don't do this to us! You dirty thieves! You wanna kill my grandparents? You come through me first!

Speaker 0: Look, relax. President Obama did not want to kill that guy's grandparents.

Speaker 3: And if he did, he wouldn't

Speaker 0: have used health insurance. He'd have just ordered a drone strike and then declared them enemy combatants. That was his style. So tonight, let's look at Obamacare. What it does, what needs fixing, and how Republicans plan to replace it.

And before we start, it's worth remembering just how bad things were before it was passed. Nearly 49 million Americans had no coverage. And if you were buying for yourself, insurers could deny anyone they considered too risky. Some denied entire professions, like air traffic controllers, taxi cab drivers, and scuba divers. And this baby was denied coverage at just 4 months old for an unexpected pre-existing condition.

Speaker 2: His parents decided to apply for individual health coverage for Alex. But they were turned down. Not because of his age, but because he was too fat. Am I supposed to put my child on a diet? Put him on a treadmill?

Of course not. He's an infant.

Speaker 0: Look, yes, I understand that you're upset, but think about it. He's never gonna lose the weight with that attitude. But the point here is, Obamacare was an attempt to solve those problems. It made it illegal to deny people coverage because of pre-existing conditions. It let people stay on their parents' plans until age 26.

It made preventive screenings free for everyone and created marketplaces where people could shop for insurance with potential subsidies. And between all that and Medicaid expansion, more than 20 million people gained coverage, putting our uninsured rate at a historic low. And yet, and yet,

Speaker 3: for many people, like this woman, whose treatment

Speaker 0: for breast cancer was covered under Obamacare, the law was just always too closely associated with the man responsible for it.

Speaker 4: I absolutely detest hearing the words, -"Obamacare." --Yeah. Detest it. It just should've been given... A more proper name. Why be named after...

Our president?

Speaker 0: Okay, well, to be clear, it did have a proper name. It was the Patient Protection and Affordable Care Act, but that does go to show you, it matters what people call something. Would Emma Stone be as popular if her real name was Blump Sharts Cracker? No, no. So, it's...

That's why it's good that she changed it.

Speaker 3: And some of the

Speaker 0: early accusations held against Obamacare still linger. Just this month, a Republican official, Bill Akins in Florida, threw out this classic at a town hall.

Speaker 2: Here's the problems I have with the Affordable Healthcare Act. Number 1, There's a provision in there that anyone over the age of 74 has to go before what is effectively a death panel. Yes, they do. Yes, they do. It's in there, folks.

You're wrong.

Speaker 7: OK, children. All right, children.

Speaker 2: It is a death panel. Who here has read the Affordable Health Care Plan? I seriously doubt that.

Speaker 0: What the fuck are you talking about? The notion of death panels isn't just a lie, it's PolitiFact's 2009 lie of the year. Which is impressive considering that in 2009, America was also repeatedly told Jason Mraz was the next big thing. We were lied to in a big way there. And look, Obamacare is not perfect.

It had and has serious flaws. The healthcare.gov website was broken on day 1, and the president famously made a very misleading promise.

Speaker 6: If you like your doctor, you will be able to keep your doctor. Period. If you like your health care plan, you will be able to keep your health care plan. Period.

Speaker 0: The truth is, No 1 can promise that. Insurers drop policies and doctors change networks all the time. That is as empty a promise as a father telling his daughter, I will always keep you safe, period. Really, Dad? What about bees?

What about angry swarms of bees? Be honest and say, I'll try to keep you safe, but these bees are not fucking around. And there have been practical problems, too. Some plans have deductibles so high, they're essentially unusable, and in many places, premiums have increased sharply, and some insurers have dropped out. Although, that was partly thanks to Republicans gutting a program in the original bill that helped protect insurers from unexpected losses.

And that has been something of a pattern here. Republicans have happily complained about the flaws in the law, taken no responsibility for fixing them, and in fact have often undermined the whole thing. But that time is now over. It is their turn to present a plan, and the clock is ticking. Insurance companies are deciding right now whether to even offer Obamacare plans next year.

But before you panic, there are ads on TV right now suggesting that Republicans have been working on something pretty special.

Speaker 4: Imagine a new path forward. Health insurance that provides more choices and better care at lower costs. House Republicans have a plan to get there without disrupting existing coverage, giving your family the health care it deserves.

Speaker 0: Well, that sounds nice, but it is a little worrying that that ad is literally encouraging you to Imagine a better health care plan. Close your eyes. Dream of a better way forward. Now open your eyes and tell us what you came up with, because we've got fucking nothing. -♪ ♪ -♪

Speaker 3: And if you think I'm kidding there...

Speaker 0: -♪

Speaker 3: That ad ends with learnmoreatabetterhealthcareplan.com.

Speaker 0: But if you go there, this is the entire website. A single page with just 2 sentences of text and the fucking ad again. And if you click on the ad, it'll send you back to the website and so on and so on and so on and so on, until you don't even want health care because you're begging for the sweet relief of death. Every time you get near something resembling a Republican plan, it seems to just recede into the distance. In January, Trump said he was working on 1, and that it was very much formulated down to the final strokes.

But watch what happened when Tom Price, his Secretary of Health and Human Services, was asked about it at his confirmation hearing.

Speaker 8: President Trump said he's working with you on a replacement plan for the ACA, which is nearly finished and will be revealed after your confirmation. Is that true? It's true that he said that, yes.

Speaker 0: -...

Speaker 3: It's funny because the president lies to us all the time with no repercussions. That's... I see what the joke we're laughing at is.

Speaker 0: Oh, dear! If you need any more proof of how unprepared Republicans are right now, let me show you 1 of the draft bills they circulated. It is just 7 pages long, and it ends abruptly with the word, -"placeholder." -$PLACEHOLDER And 1 member of Congress actually tried to spin that as a positive.

Speaker 9: This placeholder provides the clearest signal yet that we're working with patients and health care groups to draft language that balances important health status protections with necessary risk mitigation tools.

Speaker 0: Oh, please. If your spouse gave you a birthday card that said, placeholder, that would not be a signal they're working on the best language to express their feelings for you. It would signal they forgot your birthday because they're fucking Sharon from The Office, and deep down, I think you actually know that. --LAUGHTER AND APPLAUSE --The best sense we currently have of what Republicans want to do is from previous plans from both Price and Paul Ryan, and from these talking points that Ryan gave out ahead of the Congressional recess. You're gonna be hearing a few phrases from this a lot in the coming months.

So let's take a moment to understand what they actually mean. And let's start with the big 1, which Ryan has been talking up a great deal.

Speaker 10: What we believe is the right way to go, which is what our plan is, are refundable tax credits for people to go be able to buy affordable coverage.

Speaker 0: Yes, refundable tax credits. Basically, free money to help pay your premiums, which is a little surprising coming from Paul Ryan, a man who probably tips waiters by writing on the check, find a job the market has deemed has more value. But you should know, this document suggests tax credits would be based on age, not income. Meaning theoretically, 61-year-old billionaire Bill Gates would get a bigger subsidy than a 27-year-old making minimum wage. And Gates clearly does not need that money.

He'll just blow it on more $10 haircuts and orthopedic sweaters. But the real risk here is subsidies ending up too small for those who need them the most. Tom Price once proposed a credit of $1,200 to people aged 18 to 35, and $3,000 to people 50 and up, which is roughly a third of the cost of the most bare-bones plans on the market today. A tax credit that small helps cover your health insurance the way a thong covers your dad's ass. It doesn't, and there's something that is fundamentally wrong about that.

Now, the next big term in here is health savings accounts, or HSAs, tax-free accounts where you can save money to pay for health care costs. Republicans love these things.

Speaker 3: In your experience, why do these savings accounts... Why are you pushing so hard for them?

Speaker 11: Why do you think they're effective?

Speaker 12: Because you're spending your own money as opposed to someone else's. It's like when my daughter goes to the mall with my credit card, or when I go to the mall with my credit card, our purchases come back quite different.

Speaker 0: Okay, setting aside that health care is nothing like shopping at the mall. Shouldn't you come back with different purchases than your daughter, regardless of whose credit card you have? If you came back from the mall with a tongue ring, a bottle of manic panic hair dye, and a Yas Queen crop top, it would raise a lot of questions having nothing to do with healthcare. Now, the key problem with HSAs should be obvious here. They're great for rich people, they're basically a tax shelter.

But if you're too poor to save, or you get sick enough to blow through what you've saved, you're not going to be covered, and you have that thong problem again. And people seem to understand that. Just listen to the reaction when Joni Ernst tried bringing them up at a town hall.

Speaker 4: That health savings account, it is a... It is an under...

Speaker 3: 0000000!

Speaker 0: That is an appropriate reaction, when your problem is, I don't have enough money, and the proposed solution is, well, if you ever do, here's a very fancy piggy bank. So, let's move on to another key idea. Block grants. A phrase perfectly designed to bore you, because it combines block, the most nothing shape, with grant, your co-worker's nothing boyfriend. I don't believe we've met.

Yes, we have. 6 times. I'm Grant. -♪ I'm Grant. ♪ -♪ I'm Grant.

♪ Paul Ryan wants to use block grants to fund Medicaid, which largely provides health care to the poorest Americans. Basically, he wants to stop guaranteeing to pay each state a percentage of their Medicaid costs, and instead, just send them a fixed block of money. But, if costs start to rise, and the block grant doesn't keep pace, guess what? It's that thong. Thong for thong,

Speaker 3: thong, thong.

Speaker 0: -♪

Speaker 3: Thong for thong, thong, thong

Speaker 0: ♪ -♪

Speaker 3: Thong for thong, thong, thong ♪ And You should know,

Speaker 0: a few years ago, Ryan proposed a block grant program that a study estimated could kick as many as 20 and a half million people off Medicaid over a decade. That's a kind of evil so chillingly banal, you just don't see it coming. It's like if you found out that Grant was a serial killer. I kill in plain sight, for none can remember my face. I am Grant.

We've now met 7 times. -♪ ♪ -♪ ♪

Speaker 3: But now, let's move on

Speaker 0: to the final big talking point here, and I'll let Paul Ryan explain.

Speaker 10: We believe that state high-risk pools are a smarter way of guaranteeing coverage for people with pre-existing conditions.

Speaker 0: Yes, high-risk pools. Now, they may sound like something you find at Jeremy Piven's house, but What they actually do is isolate the sickest people in their own insurance group. Now, in theory, this brings everyone else's insurance rates down, but there is an obvious problem here again. Those pools are going to be incredibly expensive, which is fine if the government subsidizes them properly, but if it doesn't, that's right. It's thong o'clock, everybody.

Because 3 years ago, a study estimated that adequately funding high-risk pools just to maintain Obamacare levels of coverage would cost around $178 billion a year. Guess how much Tom Price set aside? 3000000000 over 3 years. That is 1 178th of what is needed. Imagine you asked for 178 pounds of grade A premium hunk, but instead of Chris Evans, someone brought you 6 of his severed toes.

Well, Tom Price's plan is 6 severed hunk toes. So, those are the 4 big bullet points, but perhaps the most revealing thing about this document is not what's inside it, but what is not in there. Because there is no replacement for the individual mandate. Obamacare's requirement that you have insurance or pay a penalty. And it is the thing that people hate the most.

Speaker 3: The individual mandate is unconstitutional.

Speaker 5: We gotta get rid of the individual mandate. I believe that is a freedom-killing part of the Affordable Care Act.

Speaker 12: Out the gate, that should be repealed. Get rid of the individual mandate.

Speaker 0: Who's got 2 thumbs and hates the individual mandate? This fucking guy. -♪ Yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah ♪ But the mandate keeps younger, healthier people in the system, which is crucial to lower the cost for everyone else and to keep in popular provisions, like, among other things, not punishing fat babies. The Republican solution is to make it really painful for you to get insurance again if you drop it at any point for any reason. They use the positive sounding term, continuous coverage incentive.

But it has to involve some kind of penalty. Maybe a higher premium or even denial of coverage. And they are not keen to talk about details there. Remember the placeholder from earlier? That was in place of an explanation of the continuous coverage incentive.

Basically, this is a subject so toxic, they'd rather just go abruptly silent, much like when you're a white person singing karaoke and you realize, uh-oh, we have an N-word coming up. -♪ 000000000000000... ♪ -. So, Republicans are in a real bind here. They need a plan and soon.

And what Price and Ryan have given them so far seems to shift costs from the government to the people and from the healthy to the sick. And fewer people are going to be covered. So, good luck fixing that, Republicans. Oh, and there's actually 1 more problem here, because you remember how much shit you gave President Obama for saying you can keep your doctor. Let me remind you what Donald Trump has promised that you are going to do.

Speaker 13: Everybody's gotta be covered. This is an un-Republican thing for me to say, because a lot of times they say, no, no, the lower 25 percent, they can't afford private. But... Universal healthcare. I am going to take care of everybody.

I don't care if it costs me votes or not. Everybody's gonna be taken care of much better than they're taken care of now. Who pays for it? The government's gonna pay for it, but we're gonna save so much money on the other side. But for the most part, it's going to be a private plan, and people are going to be able to go out and negotiate great plans with lots of different competition, with lots of competitors, with great companies, and they can have their doctors, they can have their plans, they can have everything.

Speaker 0: They can have everything, period! So, anything short of that is a disaster, and insurers are gonna need an answer soon, Republicans, so tick-tock, motherfuckers, because

Speaker 3: you don't get to placeholder your way out of this 1 again.

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Obamacare: Last Week Tonight with John Oliver (HBO)