海角大神

Republicans are preparing to repeal the Affordable Care Act, and have promised to replace it with something that doesn鈥檛 leave more than 20 million Americans stranded without health insurance.聽

Yet they haven鈥檛 come up with a replacement. And they won鈥檛, for three reasons.聽

First, Republicans say they want the replacement to be 鈥渕arket-based.鈥� But Obamacare is already market based 鈥� relying on private, for profit health insurers.聽

That鈥檚 already a problem. The biggest health insurers 鈥� Anthem, Aetna, Humana, Cigna, and United Health 鈥� are so big they can get the deals they want from the government by threatening to drop out of any insurance system Republicans come up with. Several have already聽聽of Obamacare.聽

Even now they鈥檙e trying to merge into聽behemoths that will be able to extort even better terms from the Republicans. 聽 聽 聽 聽 聽 聽

Second, every part of Obamacare depends on every other part. Trump聽聽he鈥檇 like to continue to bar insurers from denying coverage to individuals with preexisting conditions.聽

But this popular provision depends on healthy people being required to pay into the insurance pool, a mandate that Republicans vow to eliminate.聽

The GOP also wants to keep overall costs down, but they haven鈥檛 indicated how. More than聽聽of Americans who buy health insurance through Obamacare receive federal subsidies. Yet Republicans have no plan for raising the necessary sums.聽

Which gets us to the third big reason Republicans can鈥檛 come up with a replacement. Revoking the tax increases in Obamacare 鈥� a key part of the repeal 鈥� would make it impossible to finance these subsidies.

The two biggest of these taxes 聽鈥� a 3.8-percentage-point surtax on dividends, interest and other unearned income; and a 0.9-percentage-point increase in the payroll tax that helps fund Medicare 鈥� are also the most progressive. They apply only to people earning more than $200,000 per year.聽

Immediately repealing these taxes, as the GOP says it intends to do, will put an average of $33,000 in the hands of the richest 1 percent this year alone, and a whopping $197,000 into the hands of the top 0.1 percent,聽

It would also increase the taxes of families earning between $10,000 and $75,000 鈥� including just about all of Trump鈥檚 working class voters.聽

Worse yet, eliminating the payroll tax increase immediately pushes Medicare鈥檚 hospital fund聽聽that was looming before Obamacare became law.聽

Ultimately, the only practical answer to these three dilemmas is Medicare for all 鈥� a single payer system. But Republicans would never go for it.聽

So without Obamacare, Republicans are left with nothing. Zilch. Nada.聽

Except the prospect of more than 20 million people losing their health insurance, and a huge redistribution from the working class to the very rich.聽

This story originally appeared on .