Tag Archives: Obamacare

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Price’s Obamacare replacement would shift power to patients — which is why special interests will hate it

Donald Trump is serious about wresting control of our healthcare system away from the federal government and giving power back to patients, and he just showed it by naming Rep. Tom Price to head the Department of Health and Human Services.

Price is both an ardent opponent of Obamacare and an enthusiastic advocate for a more patient-centered healthcare system.

While virtually every Republican in Congress opposes Obamacare’s one-size-fits-all approach, Price has actually proposed detailed policy alternatives that make health insurance more affordable and accessible to patients.

Price’s plan, the Empowering Patients First Act, would improve American healthcare in three important ways. First, it would eliminate Obamacare’s provisions that increase the cost of health insurance. It would abolish the ACA’s “essential health benefits” — rules that force people to buy coverage for a range of expensive services they may not need or desire. These mandatory benefits include maternity care, newborn care, as well as pediatric vision and dental care, even if someone doesn’t have children.

Continue reading at Washington Examiner.

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The Cadillac Tax Is a Poor Solution to a Real Problem

A presidential candidate wants to repeal part of the Affordable Care Act. Normally this would not be news, but the candidate in question is Democratic frontrunner Hillary Clinton, and the ACA provision is the Cadillac Tax, a levy on expensive employer-sponsored health insurance plans. The tax is deeply unpopular—it has been delayed to 2018—and with Democratic members of Congress under heavy pressure from labor unions who oppose the tax, itcould be repealed altogether. While the tax is certainly a poorly-designed policy, it does have a real purpose, and lawmakers should have an alternative solution ready before they repeal it.

The Cadillac Tax seeks to address the unlimited tax deduction for employer-sponsored health insurance. Since there is no comparable deduction for insurance purchased individually, employers have a massive incentive to provide their employees with insurance rather than letting them purchase it on their own. Currently, 90 percent of privately insured individuals get coverage through their employers.

The deduction is problematic for many reasons. Most obviously, it costs $250 billion per year—a figure subsidized by poorer individuals whose employers do not offer health insurance. It also encourages employers to give workers raises in the form of more-expensive health insurance plans rather than cash wages, since wages are taxable and health insurance is not. These employer-sponsored health insurance plans reduce competition through “insurance lock:” since employed individuals are disincentivized from shopping for their own health coverage, insurance companies are less likely to maintain both low prices and high quality. If you want a better plan, you might have to leave your job.

Read the full piece at Economics21.

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Obamacare Is a Horror Story for Young Americans

Obamacare has enmeshed many Americans in a bureaucratic nightmare. True, the law has helped some uninsured people obtain coverage. But millions of people have seen their health-insurance plans canceled, because the plans did not meet the requirements of the Affordable Care Act. Others, particularly young Americans, have seen premiums rise to pay for the roster of newly added benefits.

Tommy Groves (not his real name), a young professional working at a small firm in Washington, D.C., was among the nearly 5 million Americans who received termination-of-coverage letters from their health-insurance providers because their plans did not comply with the ACA’s requirements. While about half the states offered to extend canceled plans for another year, later increased to two years, the District of Columbia required its residents to get new insurance.

Tommy had no choice but to grudgingly visit D.C. Health Link and attempt to sign up for an insurance plan on the ACA exchange. He did not get very far. Besides the embarrassing computer difficulties that became infamous on the state and federal exchanges, massive technological problems with “back-end functionality” also plagued the site. D.C. Health Link was unable to verify Tommy’s identity, and after hours of back-and-forth on the phone with an ACA help center, he was told to send in a paper application.

After many phone calls and countless hours on hold over a period of weeks, and despite multiple assurances to the contrary, Tommy was informed that his paper application had been lost. Finally he was directed to a place where he could sign up in person.

This attempt, too, did not succeed, as the “navigators” there had been instructed not to accept paper applications any longer. After he had spent hours more on the phone with D.C. Health Link over several additional weeks, the online system was finally able to verify his identity, and he met the deadline for purchasing health insurance. “I don’t want other people who are thrown off their employer’s health insurance to go through what I did,” Tommy told us.

“It was miserable and a complete waste of my time. Nobody listens to you. Nobody takes responsibility. The only advice I give people who are going to be stuck dealing with the health-care exchanges is, ‘Get ready for the bureaucracy.’”

Tommy’s premium for his “silver plan” went up to $225 a month from his $175 pre-ACA rate. Both plans cover the health-care services he wants, but his new plan includes services that he does not need, such as maternity care, pediatric dental care, mental-health coverage, and substance-abuse treatment. His deductible increased from $1,400 to $1,500 for in-network coverage, and from $2,800 to $3,000 for out-of-network coverage. Tommy is now paying more for coverage that is less valuable to him, and all after he was forced to spend dozens of hours on the phone.

Read the rest at National Review Online.

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Three Tough Questions for (Possible) President Ted Cruz

Sen. Ted Cruz, R-Texas, formally announced his presidential candidacy Monday, giving a laundry list of conservative positions on everything from gay marriage to abolition of the Internal Revenue Service. Although Cruz may have hit all the popular talking points of the campaign trail, President Ted Cruz would need to be ready to answer detailed questions about the consequences of his policies. Here are a few examples:

Tax Simplicity

In his announcement, Cruz said, “Instead of a tax code that crushes innovation, that imposes burdens on families struggling to make ends met, imagine a simple flat tax that lets every American fill out his or her taxes on a postcard.”

Question for Cruz: Are you prepared to eliminate popular tax credits in exchange for a simpler tax code?

Simplifying the tax code is a popular talking point, but when actually applied it means taking away popular tax credits and deductions, such as the charitable deduction, the mortgage interest deduction, and the child tax credit. According to the Treasury Department, $1.1 trillion in tax breaks are claimed by individuals, $212 billion of which is a tax break for employer-provided health insurance. Cruz might want to cut tax rates by an equal amount to create revenue-neutral reform, but the change wouldn’t affect everyone equally if the tax code suddenly stopped conferring special favor upon certain popular activities.

A dramatic simplification of the tax code might very well be worth it, but President Ted Cruz would have to admit it would require eliminating popular tax breaks, and make the case to taxpayers that the trade-offs are worth it.

Education

“Instead of a federal government that seeks to dictate school curriculum through Common Core, imagine repealing every word of Common Core. Imagine embracing school choice as the civil rights issue of the next generation that every single child, regardless of race, regardless of ethnicity, regardless of wealth or ZIP Code, every child in America has the right to a quality education. And that’s true from all of the above, whether it is public schools, or charter schools, or private schools, or Christian schools, or parochial schools, or home schools, every child.”

Question: How big should the federal role in education be? Should the federal government require all states to repeal Common Core standards? Should the federal government run its own school choice programs?

Read the rest at the Washington Examiner…

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How to Handle Victory in King v. Burwell

On Wednesday, the Supreme Court heard oral arguments in King v. Burwell, a legal challenge to the provision of President Obama’s national healthcare law that subsidizes insurance premiums for those enrolled in federal health exchanges.

The justices considered whether the IRS acted outside its authority when it permitted subsidies to healthcare.gov enrollees in the 37 states that did not establish their own insurance exchanges.

The plaintiffs had a strong case, as the letter of the law states that subsidies are available only “through an Exchange established by the State.” The IRS defined a state exchange as a “State Exchange, regional Exchange, subsidiary Exchange, and Federally-facilitated Exchange,” taking the pressure off states to establish their own exchanges. The subsidies were designed to encourage the creation of state exchanges.

What should be done if the IRS’s actions are found to be illegal? One interesting post-Kingproposal comes from Galen Institute President Grace-Marie Turner and Economics21 Director Diana Furchtgott-Roth.

A Supreme Court ruling in favor of the plaintiffs would force Congress and President Obama to the negotiating table. Besides passing legislation that allows already-promised subsides to remain, this could be used as an opportunity to return flexibility and state control to health insurance markets.

As Turner and Furchtgott-Roth explain, “the 37 states without exchanges could receive a new, capped allotment from the federal government that we call Health Checks. States could use the allocation to provide immediate premium assistance to people affected by the court decision, and similar checks could be extended to others who would need insurance afterward.”

Read the rest at the Washington Examiner…