Before we discuss what should replace Obamacare it would be a valuable exercise to revisit what needs to be repealed.
- The employer mandate has to go. It’s hurting the very people it was designed to help.
- The individual mandate has to go. It’s forcing people to buy something they don’t want.
- Regulations guaranteeing coverage regardless of health status are not sustainable. Premiums are reaching the stratosphere and there is a perverse incentive to game the system.
Representative Tom Price reports a bill with a proposal to replace Obamacare will soon follow. The following are some of the elements that a new Obamacare replacement bill should include.
- The open-ended tax exclusion should be converted to a fixed sum. This could be adjusted for age, health status or some other factor. But the government should subsidize core needs not marginal spending on Cadillac plans.
- Community rating should be used only to create beneficial incentives; not to increase cross-subsidies. The right to buy insurance at modified community-rated premiums needs to be conditioned on continuation coverage. A regulation such as guaranteed renewability would not allow people go years without coverage and then expect others to subsidize their decisions.
- Americans deserve the right to purchase the coverage of their choice; not the coverage Obamacare proponents believe Americans should have. This means affordable coverage with limited benefits, high-deductibles or coverage that rewards them for taking care of their health if that’s what consumers want.
- Americans should be protected from surprise medical bills (but not necessarily from high medical bills) – ones where patients cannot ascertain prices in advance or verify that doctors providing care are even in their network. Public policy should encourage discussions about prices between doctors and patients — not reward barriers to competition.
- The federal government should grant states the flexibility to design Medicaid programs that meet states’ needs. The federal government should not match state Medicaid funds. Rather, it should negotiate a block grant and a state contribution; and make states pay for all cost overruns. States should have the authority to design innovative Medicaid benefits, where some beneficiaries pay premiums, experience nontrivial cost-sharing, pay a penalty for inappropriate emergency room use and have work requirements. Moreover, states should have the authority to kick beneficiaries off the Medicaid rolls who break eligibility rules.
These are just a few of our ideas. What are your thoughts? Give us your comments and tell me what have we have missed?