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The election of Donald Trump with a Republican-majority Congress is proving once again that conservative economic policy largely reduces to cutting taxes, mostly for the rich.

But wait a second, arent they also wading into health care reform?

They are, and it proves my point. While much attention is reasonably focused on how theyre all repeal with no replace and how thats likely to reverse the coverage gains weve seen and undermine insurance markets theres something else going on here. And that is a big tax cut for the rich.

The Affordable Care Act has provided health insurance coverage to 20 million people, bringing the uninsured rate to an all-time low of 9.1 percent, from 16 percent before the reform was enacted. And most of the revenue the ACA raised flows from some very rich waters.

If the law is repealed without a replacement, tens of millions of people are expected to lose coverage. But the other side of that is a big tax cut for the wealthiest Americans.

Just how fat of a tax cut? That question is answered in a new report by three of my colleagues at the Center on Budget and Policy Priorities. Using IRS data, they show that the 400 richest Americans, whose average annual income is more than $300 million, each would get an average $7 million kickback from ending two ACA taxes: the 0.9 percent Hospital Insurance tax and the 3.8 percent unearned income Medicare tax.

The base for both taxes are individuals with incomes of more than $200,000 and couples with incomes of more than $250,000, making this a highly progressive revenue source. That also means the 160 million households with incomes below these levels get no tax benefits from repealing those taxes.

As my CBPP colleagues point out, ACA repeal would significantly raise taxes on about 7 million low- and moderate-income families due to the loss of their premium tax credits worth an average of $4,800 in 2017 that help them buy health coverage through the health insurance marketplaces and afford to go to the doctor when needed. In fact, the repeal leads to the richest 400 households getting a $2.8 billion tax break thats bigger than the value of almost 670,000 ACA tax credits worth $2.5 billion going to people in Pennsylvania, Wisconsin and Michigan.

This isnt just the usual Robin Hood in reverse weve come to expect from Republican tax plans: This is Robin Hood slamming the Batmobile into reverse at 100 mph.

Recent news reports tell of a few Republicans worrying that repeal might be courting more trouble than their colleagues realize. After six years of the fight to kill the ACA, the repealers have few ideas for replacement. The ideas they have floated high deductible plans, health savings accounts, block grants for Medicaid and vouchers for Medicare all shift more costs onto regular people relative to the current system. That is the only possible outcome when you so deeply cut health care resources.

So perhaps the ACA repeal will founder on the shoals of political reality, but I doubt it. Reality isnt exactly constraining this crew.

Jared Bernstein, a former chief economist to former Vice President Joe Biden, is a senior fellow at the Center on Budget and Policy Priorities.

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How Republican-style health care reform becomes a tax cut for the richest of the rich - Columbia Daily Tribune