President Obama reflected upon the Affordable Care Act in an article published this week in the Journal of the American Medical Association. He acknowledged the law’s shortcomings and outlined what he believes to be the next steps in health care reform.
The President concluded, “Policy makers should build on progress made by the Affordable Care Act by continuing to implement the Health Insurance Marketplaces and delivery system reform, increasing federal financial assistance for Marketplace enrollees, introducing a public plan option in areas lacking individual market competition, and taking actions to reduce prescription drug costs.”
. . .
President Obama on Monday called on Congress to revisit the controversial idea of providing a government-run insurance plan as part of the offerings under the Affordable Care Act.
What’s been described as the “public option” was jettisoned from the health law in 2009 by a handful of conservative Democrats in the Senate. Every Democrat’s vote was needed to pass the bill in the face of unanimous Republican opposition.
But in a “special communication” article published Monday on the website of JAMA, the American Medical Association’s top journal, the president says a lack of competition among insurance plan offerings in some regions may warrant a new look.
. . .
The release of the House GOP health-care plan last month was a milestone event in the long-running debate over the future of health care in the United States. Republican leaders had been promising to repeal and replace the Affordable Care Act — a.k.a. Obamacare — since it was enacted in 2010. But this is the first time that GOP leaders in Congress have presented a plan that could accurately be described as “the Republican alternative.” If the GOP is in a position in Congress to take up health-care legislation in 2017 (or later), this plan will almost certainly be the starting point.
House Speaker Paul Ryan deserves the credit for making this happen. He announced last fall after taking over the speakership that he wanted the GOP to offer a proactive agenda in order to give voters a clear idea of what Republicans would do if given the opportunity to govern. He followed through on that promise by getting his House colleagues to support plans for top-to-bottom reform of most key responsibilities of the federal government.
. . .
A federal appeals court has ruled that consumers must be allowed to buy certain types of health insurance that do not meet the stringent standards of the Affordable Care Act, deciding that the administration had gone beyond the terms of federal law.
The court struck down a rule issued by the Obama administration that barred the sale of such insurance as a separate stand-alone product. “Disagreeing with Congress’s expressly codified policy choices isn’t a luxury administrative agencies enjoy,” the United States Court of Appeals for the District of Columbia Circuit said on Friday in a decision that criticized “administrative overreach” by the Department of Health and Human Services.
At issue is a type of insurance that pays consumers a fixed dollar amount, such as $500 a day for hospital care or $50 for a doctor’s visit, regardless of how much is actually owed to the provider.
. . .
Last week, the GOP kept a promise to the American people by delivering a replacement plan for Obamacare.
The plan — part of the party’s “A Better Way” campaign — was unveiled by House Speaker Paul Ryan, R-Wisc. “What we are laying out today is a first-time-in-six-years consensus by the Republicans in the House on what we replace Obamacare with,” he said.
The plan is a good one. House Republicans have laid out several core reform proposals their party can rally around. As I note in my new book The Way Out of Obamacare, a plan like this one would be a vast improvement over the unmitigated disaster that is Obamacare.
. . .
The House Republican’s health plan represents a real milestone. It is the first proposal released since the enactment of the ACA in 2010 that legitimately can be called the Republican alternative. If Congress were to take up legislation in 2017 to roll back the ACA and replace it with something different, the starting point for drafting the legislation would be this plan. It builds on plans authored by Sen. Richard Burr, Sen. Orrin Hatch, and Rep. Fred Upton as well as the plan introduced by Rep. Tom Price. These precursors were built on the same set of common principles and objectives: repeal and replacement of the ACA; more choices, lower costs, and greater flexibility for consumers; protection of the most vulnerable Americans; incentives for innovation and high quality medical care; and preservation and protection of Medicare.
. . .
The health care law President Obama signed six years ago was supposed to fix the individual insurance market with enlightened rules and regulations. Instead, ObamaCare is destroying this market. Just look at what’s happening to Blue Cross Blue Shield.
If any insurer could cope with ObamaCare, it should have been Blue Cross Blue Shield.
Blue Cross companies came into the ObamaCare exchanges with decades of experience writing individual policies. Most of them are non-profits, which gives them an automatic leg up on the competition. And their plans captured the largest share of the exchange markets across the country.
. . .
Sen. Lamar Alexander says he’s more than happy to strike deals with Democrats — even on Obamacare.
“Whoever the president is in January, we’re going to have to take a good, hard look at Obamacare,” the powerful chairman of the Senate HELP committee told POLITICO’s “Pulse Check” podcast. “It can’t continue the way it is.”
Alexander laid out several changes that he’d like to see in health care: Less government “management,” more support of private sector innovation and more flexibility for states on Medicaid. He also credited House Speaker Paul Ryan’s recent white paper that summarized Republican health care proposals as a “helpful” starting point, though he didn’t explicitly endorse the House GOP’s insistence on replacing the whole law.
Ryan’s plan embraces the idea that refundable tax credits can be used to give people universal access to “quality, affordable health care.” It recognizes that we can’t return to the pre-Obamacare status quo, which was too arbitrary, too expensive, and too bureaucratic. It concedes that reforming Medicaid—including Obamacare’s Medicaid expansion—will be a gradual process, requiring a new infusion of federal funds to help cajole states into reforming their own health-care markets (which were hardly free and efficient before Obamacare).
These reforms envision portable, affordable coverage. Routine health expenses would be channeled through Health Savings Accounts. Private exchanges would compete to offer affordable insurance—as they already do for employers. Currently, employers’ spending on health insurance plans is tax-deductible and uncapped—meaning that if organizations want to buy $100,000 health plans and write them off, they can.
. . .
The Republican House is methodically laying out a comprehensive agenda to spread prosperity, protect the nation, uphold the Constitution, reform health care, and—with its presentation Friday of a comprehensive tax-reform plan—create jobs, grow paychecks and boost the economy.
This agenda, dubbed “A Better Way: Our Vision for a Confident America,” is Speaker Paul Ryan’s brainchild, but the work of the entire Republican conference.
Mr. Ryan rolled out its first plank June 7 with an audacious reimagining of policies to help Americans rise out of poverty. The initiative would require those on welfare to seek work while providing them better access to job training and assistance. It would reform poverty-fighting programs to help people move from dependency on government to lives of independence and personal responsibility.
. . .