The Chinese have a saying (and really a curse) that goes may you live in interesting times. And by that measure, last week was pretty “interesting” in health care news as Sen. Bernie Sanders unveiled a bill to create a single payer approach for the nation’s health care system. Just like we talked about when this came up in California earlier this year, this “throw the baby out with the bath water” approach seems great and sounds SO great, but in our opinion this “Medicare for All” bill would be a catastrophe for our economy and the quality and availability of health care services in this country.
Instead, some good old-fashioned bipartisan compromise might just hold the answer to stabilizing things as discussed in the Washington Post recently by Bill Frist and Andy Slavitt. Their recommendations are as follows:
First — and most important — Congress should act to cut average premiums by 20 percent nationally. Lawmakers should commit to funding cost-sharing reduction subsidies for insurance companies in the ACA exchanges for 2018 and 2019. These payments reduce the size of deductibles for low-income people and are already accounted for in the federal budget. But the timing of this measure is critical. Congress and the president have only weeks to positively affect next year’s premiums. Moore’s opinion — yes, and hooray if that could happen.
Congress should establish a targeted fund for states to use to bring down premiums. The cost of insurance for all of us can be affected by even a small number of expensive patients with complex medical conditions. Innovative efforts, as we have seen in Alaska, have demonstrated that this approach works. Moore’s take —So federal dollars (ours) would be used as a stop-loss for states to avoid catastrophic losses. Ok, if there is a corresponding plan to prevent and mitigate these dreaded diseases.
Third, the federal government should cut its review time for approving state innovation applications in half, to a 90-day maximum. The ACA has provided states — such as Alaska — the opportunity to waive various provisions of the law with local innovations as long as important consumer protections are kept in place. Only two have been approved so far, but many more states have submitted applications, a pattern we hope continues. Done right, these innovations can improve competition and choice and reduce premiums while maintaining important protections. Moore’s take — Yes, please!
Fourth, Congress should help middle-income consumers manage the size of their deductibles. It can do this by allowing consumers to temporarily increase the amount of money they can set aside for pretax health saving account contributions for 2018 and 2019 to equal the out-of-pocket limits for high-quality health plans. Moore’s take — yes, this is a good one.
Finally, the federal government should develop alternatives that allow states beginning in 2020 to potentially replace the ACA’s mandate that most individuals buy coverage or face a penalty. The individual mandate plays an important role in keeping premiums low but is also unpopular with the American public. So even while this mandate is enforced, Congress should direct the administration to explore an option similar to one used in Medicare — automatically enrolling consumers in low-cost coverage and providing incentives to enroll on time. Moore’s take — yes, this is a huge sticking point that prevents anything from getting done.
Yes, health care is pretty “interesting” right now, but there are some alternatives other than scrapping the entire system for a full gov’t takeover, which just isn’t going to be pretty if it ever happens. As we always say, the current law is STILL the law until the law changes so don’t get too confused by all of this and make sure YOUR company stays in compliance. If you have any questions about any of this messy stuff, my amazing team of experts is standing by to assist you. We promise to keep things interesting!
Five bipartisan steps toward stabilizing our health-care system