The WasteWatcher: The Staff Blog of Citizens Against Government Waste

Health Care Choices Proposal: A Plan to Return Power Back to the People and States

The WasteWatcher is the staff blog of Citizens Against Government Waste (CAGW) and the Council for Citizens Against Government Waste (CCAGW). For questions, contact blog@cagw.org.


In June, Senate Minority Leader Chuck Schumer (D-N.Y.) declared that August should be healthcare month.  The senator would prefer to talk about how to prop up the Patient Protection and Affordable Care Act (Obamacare), or perhaps Sen. Bernie Sanders’ Medicare for All Act that would bankrupt the country, anything to avoid voting for President Trump’s judicial nominees. 

But, Citizens Against Government Waste (CAGW) believes August would be a good time for senators to consider the Health Care Choices Proposal.

Announced two months ago, this health reform plan has been under development for almost a year, with the leadership of the Health Policy Consensus Group, an organization composed of free-market and patient-centered healthcare policy wonks, including national and state experts, and fiscally conservative taxpayer watchdog groups like CAGW.  The members of the Health Policy Consensus Group have not given up on the imperative of ridding the nation of Obamacare.

Their plan would allow Americans to get the healthcare they want and need without the massive, Washington, D.C. centralized government interference that has driven up premium costs and reduced choice.

Obamacare is failing and has been since it first was delivered to Americans in 2014.  The law forced people to purchase insurance plans and coverage policies they did not want or need, such as requiring a single man to purchase maternity and pediatric care.  Healthy people, particularly those between the ages of 18 and 35, were needed in the insurance pool to keep premiums stable.  Instead, after getting a look at the exorbitant costs, those folks behaved rationally and opted not to participate at all.  They chose instead to pay the penalty, or tax, for not buying the health insurance.

Most of the newly insured under Obamacare are a result of Medicaid expansion, which allows healthy, childless, abled-bodied adults with incomes up to 138 percent of the federal poverty level to sign up for the joint federal and state healthcare program.  However, Medicaid expansion has altered the original purpose of the safety net, government-sponsored health insurance program.  States that adopted Medicaid expansion receive a much larger federal payment for the expansion cohort compared to the historic Medicaid population of low-income children, pregnant women, parents of dependent children, the elderly, and individuals with disabilities.  As a result, states favor coverage for the expansion population over limited services and providing timely access for their most vulnerable citizens.

Since Obamacare’s inception, deductibles and premiums have continued to climb, networks have shrunk, and insurers have abandoned large areas of the country due to heavy financial losses.  According to a November 2017 Kaiser Family Foundation report, the average number of health insurance companies for the 2018 Obamacare marketplace exchanges were 3.5 per state.  Several states only have one insurer: Alaska, Delaware, Iowa, Mississippi, Nebraska, Oklahoma, South Carolina, and Wyoming.

Because Obamacare has so distorted our healthcare system, the Health Policy Consensus Group has never given up on trying to replace it.  Their plan would essentially take all the federal money currently given to insurance companies to prop up Obamacare and send it to the states in the form of block grants.  These grants would be used to help those with low incomes and pre-existing conditions get access to care from the doctors and plans they choose.  The grants would initially be based on the amount of Obamacare spending, which includes Medicaid expansion funding, tax credits, and subsidies, on a fixed date.  Eventually, the individual state grants would be based on the total number of their low-income residents.

States would once again oversee regulating health insurance, as opposed to Washington, D.C.’s one-size-fits-all heavy-handedness, because what works in one state or region, may not work in another.  States would no longer be compelled to follow Obamacare’s onerous mandates that drove up costs and raised premiums.

This does not mean states could use the grant money for whatever they wanted.  States would have to ensure to:

  • Provide at least 50 percent of the funds to support a person purchasing private health coverage;
  • Provide at least 50 percent of the funds to assist low income people (the first two would overlap one another);
  • Use part of the grant to offset the costs of people with pre-existing conditions but not drive up premiums for everyone else; and
  • Allow those eligible for financial assistance under the block grant, Children’s Health Insurance Program (CHIP), or Medicaid use this funding to purchase a private plan of their choice.

 

The proposal would also expand the use of and increase contribution limits for health savings accounts (HSAs).

Former Sen. Rick Santorum (R-Penn.) has been passionate about the reform proposal and has been working diligently with current senators to get a bill to the floor for a vote.  When he saw what happened to Charlie Gard and Alfie Evans in England, where the government, not their parents, made the decisions on the treatment these children would receive, Santorum knew a socialistic and centralized government health plan would not protect patients with serious ailments, like his child, Bella, who was born with Trisomy 18, a rare genetic disorder.  Most children with Trisomy 18 die within the first year; but Bella celebrated her tenth birthday this year.  Santorum fights everyday so that children like Bella, their parents, and others in the future will have the freedom to get the medical care they need without government interference.

Elected leaders and health policy experts from around the country are lining up to support this initiative (more about it here.)  Governors Matt Bevin (R-Ky.) and Phil Bryant (R-Miss.) have expressed strong support and Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.) are working hard to make the proposal a reality.  What needs to happen is for average Americans to demand that the Health Care Choices Proposal be introduced as a bill and voted on in the Senate and the House of Representatives.

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