The COVID-19 pandemic has put the American health care system to a severe test, revealing both its strengths and weaknesses in delivering affordable care to patients, states a comprehensive reform proposal released by the American Action Forum’s (AAF) Health Policy Consensus Group.
The proposal released on October 20 states the nation’s health care system “has shown its flexibility and adaptability in saving countless lives, quickly mobilizing research and manufacturing capacity to develop treatments and vaccines and pivoting to telemedicine in a matter of days, enabling medical professionals to do everything from providing routine care to performing virtual triage in order to protect medical staff and patients from possible COVID-19 exposure.”
In addition to those positive developments, the pandemic “has also exposed how government red tape gets in the way of a rapid response and interferes with patients being able to quickly and efficiently get the care they need from those they trust most,” the proposal document states.
The reform package, “Health Care Choices 2020: A Vision for the Future,” was developed by medical professionals, state and national health policy experts, and organizations dedicated to providing relief from high costs through more coverage options that emphasize choice, not mandates.
Increasing Options, Transparency
“Health Care Choices 2020” proposes to make patients better off in at least 10 ways:
- empowering people to keep their health coverage when they change or lose their job, by codifying and improving the Trump administration’s Health Reimbursement Arrangement (HRA) rule that allows employers to offer and employees to use tax-free dollars to buy insurance they can keep if they lose or change jobs, and letting low-income patients use the value of their existing government coverage to enroll in better, private health plans, including employer-sponsored coverage;
- enabling people to save money on health care and drugs, by codifying the Trump administration’s transparency rules so patients can compare prices and obtain the best value;
- eliminating surprise bills through transparency and truth in advertising;
- enabling people to choose a lower-cost alternative that best suits their needs, by eliminating barriers that keep people from shopping for value;
- replacing the current practice in which Congress sends money to states and imposes burdensome mandates that drive up the cost of coverage, by converting the subsidies that currently go to Medicaid expansion and health insurance tax credits to Health Care Choices Grants to the states to support coverage for lower-income and vulnerable patients;
- promoting insurance plans that include centers of excellence catering to patients with specific medical problems, such as heart disease or diabetes, by having Congress eliminate barriers to this option;
- giving patients more options for insurance and care tailored to their needs, by codifying the Trump administration’s rules on Association Health Plans and enabling consumers to choose a direct primary care doctor or join a health care sharing ministry;
- making it easier for Americans to manage their own health care dollars, by allowing seniors on Medicare to contribute to health savings accounts to which they would have flexible access;
- making telehealth permanent by removing barriers that restrict its use to the duration of the COVID-19 emergency; and
- abolishing certificate-of-need laws that create barriers to entry and rules that prevent providers from practicing at the top of their education and training.
Empowering States, Individuals
The plan would protect people with preexisting conditions, says Grace-Marie Turner, president of the Galen Institute and one of the facilitators of the Health Policy Consensus Group.
“The centerpiece of the Health Care Choices proposal would devolve power and control away from Washington by replacing ObamaCare’s entitlements with grants to the states,” Turner wrote in The Hill on October 16. “Our proposal would devote a portion of the grant to fully support people with pre-existing conditions, without all the collateral damage inflicted by Obamacare.”
Lower Costs, Greater Access
The Heritage Foundation commissioned the Center for Health and the Economy (H&E) to carry out a score, or economic analysis, of the reform proposal. H&E economists Douglas Holtz-Eakin and Christopher Holt conclude the plan would reduce prices and increase access to care. Their figures assume implementation of the proposal at the beginning of 2022.
Holtz-Eakin and Holt project that the proposal would decrease the cost of premiums for private individual market health insurance coverage. The largest impact would be on silver plans, for which premiums would decrease by 18 to 24 percent beginning in 2022, relative to the baseline.
The proposal is projected to result in nearly four million more people purchasing insurance by 2030, with enrollment holding steady early in the budget window. The proposal would also result in more people enrolling in private coverage versus public insurance.
The proposal would lead to an 8 percent increase in consumer access to a provider by 2030, the economists project.
The proposal would decrease federal spending by $36 billion for the years 2022 to 2030, Holtz-Eakin and Holt found.
Expanding on Prior Reforms
The authors of the proposal intended it as a blueprint for health care reform in a second Trump administration and as a policy alternative to a larger government role for health care expected under a Biden administration.
“The Trump administration has already made major progress on many of these ideas under the pandemic emergency, but the changes are not permanent, and many will go away,” said John Goodman, president of the Goodman Institute and co-publisher of Health Care News. “Congress needs to secure these reforms in the law.”
Bonner R. Cohen, Ph.D., (email@example.com) is a senior fellow at the National Center for Public Policy Research.
Health Policy Consensus Group, “Health Care Choices 2020: A Vision for the Future,” October 2020: https://www.healthcarechoices2020.org/wp-content/uploads/2020/10/HEALTH-CARE-CHOICES-2020_A-Vision-for-the-Future_FINAL-002-1.pdf
Douglas Holtz-Eakin, Christopher Holt, “The Health Care Choices Proposal,” October 2020: https://www.healthcarechoices2020.org/wp-content/uploads/2020/10/The-Health-Care-Choices-Proposal-Score.pdf