A Republican Plan for Healthcare
The WasteWatcher
The Republican Study Committee (RSC), the largest conservative caucus in the House of Representatives, has released a proposal to improve healthcare in the United States. It accomplishes this, not by giving more power to the government but by giving power back to the states and the individual.
The plan, “A Framework for Personalized, Affordable Care,” is focused in its approach and the changes it makes would be powerful and substantial. The key words the designers of the plan want you to remember are "protects, empowers, and personalizes." I urge you to read it.
RSC Chairman Mike Johnson (R-La.) and RSC Health Care Task Force Chairman Roger Marshall, M.D., (R-Kan.) along with the members of the task force, state in the introductory page, “It is a plan that protects the vulnerable – especially those with pre-existing conditions; empowers individuals with greater control over their health care choices and dollars; and personalizes health care to meet individual needs and reduce premiums, deductibles, and the overall cost of health care.”
The plan codifies many of the good ideas the Trump administration has implemented, such as Association Health Plans and extended use of Short-Term, Limited-Duration plans. This is important because these ideas have been implemented by guidance or regulation, which could be eliminated by a future administration.
The increased flexibility the RSC plan provides to the states is similar to what the Trump administration has done by expanding the use Section 1332 State Innovation Waivers, which is found in the Patient Protection and Affordable Care Act (ACA), or Obamacare. States have been using these waivers to lower premiums while still protecting those with pre-existing conditions obtain affordable insurance.
The authors of the plan point out that Obamacare advocates have “sought to weaponize the issue of ‘pre-existing conditions’ as a means to get their new law passed. The result has been that a vulnerable population of Americans has been used as political pawns. To extend insurance to individuals with pre-existing conditions, the ACA imposed a new regulatory scheme consisting of onerous mandates and laws that forced all Americans into insurance plans they did not need and could not afford.”
Proponents of ACA continue to do that today and demagogue anyone that offers an alternative or an improvement to current law.
The main provisions of the RSC plan include:
- Unwinding ACA’s “Washington-centric approach” and returns most of the regulatory authority back to the states;
- Undoing ACA’s expensive and mandatory essential health benefits, annual lifetime limits, preventive care with no cost-sharing, dependent coverage, and metal actuarial tiers (bronze, silver etc.), and allows states to prescribe these principles;
- Not allowing insurance carriers to rescind, increase rates, or refuse to renew a person’s health insurance if they should develop an illness after enrollment;
- Allowing individuals with chronic and risky medical conditions to have access to affordable state-run Guaranteed Coverage Pools, subsidized by federal grants;
- Restructuring the guaranteed issue and prohibition on coverage exclusions to reward continuous coverage and promote portability in the individual marketplace;
- Restructuring ACA premium subsidies and Medicaid Expansion federal matching programs to fund state-administered grants to subsidize health insurance for low-income individuals, while protecting the medically vulnerable, such as low-income pregnant woman and children, that Medicaid was created to help;
- Changing the tax code to provide for equal treatment of employer and individual health insurance markets;
- Expanding the use of pre-tax Health Savings Accounts (HSA), including using them to pay for insurance premiums, and increases allowable yearly contributions from $3,500 to $9,000 for individuals and from $7,000 to $18,000 for families;
- Extending portability protections (contained in the 1996 Health Insurance Portability and Accountability Act for employer-sponsored health insurance) to the individual market;
- Eliminating the employer mandate; and
- Promoting the use of innovative healthcare solutions such as telemedicine, direct primary care, association health plans, and health sharing ministries.
The proposal provides a good overview of the problems that Obamacare caused, such as sky-high premiums and forcing people to buy health insurance plans that contain mandatory benefits they did not want or need, such as a single man paying for maternity care. It explains how Obamacare has distorted the job market with the employer mandate and how Medicaid Expansion hurt the vulnerable by extending the program to abled-bodied individuals without dependents that compete with traditional Medicaid recipients, such as poor, pregnant women, looking for care.
The RSC healthcare reform proposal is a strong and effective antidote to "Medicare for All" that would cost $32 trillion in new taxes and force everyone into a government-run system.
The next time you hear someone say the Republicans have no plan to improve healthcare, you can tell them they are wrong and point to the RSC plan.