Under the status quo, many employees have neither the motivation nor the wherewithal to shop for the best care at the best price. The GOP plan would provide a $5,700 refundable tax credit to families, but workers would pay income tax on their employers' contributions.
Savings could result in one of two ways. Employers would have more flexibility in choosing coverage. Or employees could choose their own plan -- and take it with them if they wanted to start a business.
The result would be universal care but in a system, Ryan told me in an interview, that "reconnects the buyer and the seller." The downside: It could be more work for consumers. The upside: Employees actually might be able to pocket future raises instead of handing them over to an insurance company.