Today, Sens. Tom Coburn and Richard Burr and Reps. Paul Ryan and Devin Nunes introduce the Patients’ Choice Act — the best Republican alternative to Democrat socialized medicine.
Today, the leading Republican health care reform alternative, The Patients’ Choice Act, will be introduced in the Senate by Senators Tom Coburn (R-OK) and Richard Burr (R-NC), and in the House by Reps. Paul Ryan (R-WI) and Devin Nunes (R-CA). The bill would assure essential health coverage and health care to every U.S. citizen, without increased federal spending and taxes, and without the federal government taking over your health care. For precisely those reasons, today’s left wing Democrats will not support it.
The key to the bill is that it shifts the tax benefits for employer provided health insurance from corporations to all workers. As a result, every citizen not retired on Medicare will get a refundable tax credit of $2,300 per year for individual health insurance or $5,700 per year for family coverage. For workers who don’t have insurance now or who pay for their own insurance, that is thousands of dollars a year they don’t have today to help pay for health insurance. Workers with employer-provided coverage can keep that or use these credits to purchase their own preferred insurance instead.
This immediately shifts health care power to workers and patients, who would be the ones making health insurance choices rather than employers. All consumers would be free to choose from the full range of coverage alternatives available in the marketplace, from Health Savings Accounts (HSAs) to Health Maintenance Organizations (HMOs) to standard fee-for-service coverage with different health provider network arrangements. The consumer could choose coverage options with maximum choice of doctors and hospitals and alternative treatments and care, like HSAs, or could choose coverage where the insurer takes responsibility for managing health care in return for lower premiums, like HMOs. Workers can take the health insurance they choose with them when they change jobs, as this new system makes such insurance fully portable.
Under the bill, each state would set up their own Health Insurance Exchange, where insurers could compete to offer coverage to everyone in the state. All insurance offered on the Exchange would have to provide coverage meeting the same standards as the insurance offered to federal employees and members of Congress under the Federal Employee Health Benefits System. This would ensure comprehensive coverage. But insurers could offer, and consumers could choose to buy, insurance coverage outside the Exchange.
The bill would also enable employers to devote a specified amount towards health coverage for each worker each month, with the worker to then use those funds to buy the health plan of his choice on the state Exchange, or outside the Exchange. This could potentially increase employer provided coverage quite substantially, because the employer would not have to carry the burden of choosing and administering a health plan, or commit to paying the full cost of such a plan, with unknown future cost increases. This would be particularly attractive to small and medium size businesses. Yet, the worker would still gain full control and choice over his or her coverage.
States could join with others to form regional Health Insurance Exchanges that would expand insurance options. Consumers in each state in a regional Exchange would be free to purchase health insurance from any other state in the Exchange.
A Health Care Safety Net
Insurance offered on the state Exchanges would have to be open to everyone, regardless of age or health condition. A non-profit, independent board in each state would provide reinsurance risk adjustments among insurers, shifting funds from insurers with healthier patients to those with sicker patients. This would provide incentives and the essential financing for insurers to cover the sickest patients as well as the healthiest. No insurance company, whether offering coverage through an Exchange or not, would be allowed to cancel coverage or charge discriminatory premiums for a covered consumer after he became sick or suffered deteriorated health.
Each state would also set up an uninsurable risk pool, ensuring that a coverage option is available even to the sickest consumers in their state. Those without coverage who suffer costly and serious illnesses could always obtain coverage from the pool. They would be charged what they can reasonably pay based on their incomes, with remaining costs covered by state payments into the pool. States could choose to use some of their federal Medicaid funds for such pools, which already operate successfully in many states.
Medicaid is projected to cost almost $5 trillion over the next 10 years, reaching $674 billion for 2017. Yet, about 40% of doctors and hospitals do not accept Medicaid patients because of the very low payments the system offers them. This restricts access to health care for the poor served by the program, as they have to scramble for short and hurried appointments with available doctors, or wait for available hospital care. The result is worse health outcomes for the poor on Medicaid, including more and earlier deaths from heart disease or cancer.
To address this, in addition to the tax credits for health insurance, the bill would enable low income consumers to choose to receive additional funds from Medicaid to help pay for private insurance coverage, like a health insurance voucher. This would enable the poor on Medicaid to receive the same private coverage and care on the same terms as everyone else.
The bill consequently provides a complete health care safety net ensuring that no one will fall through the cracks without essential coverage or care. The bill assures that coverage is available to everyone, even the sickest with pre-existing conditions.
Health Savings Accounts
Since 2005, HSA coverage has increased 6 fold, growing at a rate of over 30% a year. With an HSA, the worker gets health insurance covering expenses over a high deductible chosen by the worker, usually $2,000 - $5,000. The enormous savings from such a high deductible policy is then kept in the HSA account, where it earns interest tax free. Funds in the account can then be used to pay for health expenses below the deductible, again tax free. The savings are frequently enough to cover almost the entire deductible, and would certainly do so by the second year of such coverage. Money left in the account at the end of the year rolls over to the next year, and can accumulate to substantial amounts over time. The worker can withdraw remaining funds for any personal use in retirement.
A man of faith in a godless age is hitting Americans where it hurts.
Mr. and Mrs. American Spectator Reader, let P.J. O’Rourke talk sense to your kids.
In Britain, defending your property can get you life.
It won’t take long for conservatives to scratch this presidential wannabe off their 2008 scorecard.
Was the President done in by the economy, or by the politics of the economy?
H/T to National Review Online