With the help of scholars at the Goodman institute and Americans for Prosperity, Congressman Pete Sessions and his colleagues have introduced the Health Care Fairness for All Act. Among its other features, the bill would do the following:
1. For the first time in the history of the tax code, the government would give everyone the same assistance in purchasing health insurance – whether at work, in the (Obamacare) exchange, or outside the exchange. The same commitment is made even to people who remain uninsured: the assistance would go to a safety net in case they cannot pay their medical bills. [Under the current system, a family of four earning $45,000 gets five times more tax relief than people who get the same health insurance through an employer. Among high-income families, this unfairness is completely reversed.]
2. Unlike the current system, families will be able to buy insurance that meets their financial and medical needs. [The average deductible plus the average premium for a family of four in the (Obamacare) exchange is more than $25,000 for people who do not get a subsidy. This is “unaffordable” insurance.]
3. Private insurance will be free to meet people’s needs in a competitive marketplace. Any needs that are not met by the private sector will be met through an expanded safety net (e.g., Jimmy Kimmel’s million-dollar, premature baby).
4. Employer plans and people in the Obamacare exchanges are grandfathered — they can stay in the current system if they choose to do so.
5. The bill codifies ten reforms that have been endorsed by more than 80 think tanks and activist organizations as part of Health Care Choices, including telemedicine, direct primary care, portable insurance, and flexible Health Savings Accounts.
The bill updates and improves the bill previously introduced by Congressman Sessions and Senator Bill Cassidy.
he bill is a pro-patient, pro-family, pro-free-enterprise alternative to the Medicare-For-All proposal, backed by Sen. Bernie Sanders and others on the left. It is based on a new and better vision:
A New Vison for Health Care
1. Everyone should have access to the best care the American health care system has to offer, regardless of income, assets, insurance coverage or health care status.
2. The purpose of private health insurance is to protect income and assets, not to get access to health care.
3. People should be free to buy health insurance that meets their financial and health care needs, instead of being forced to buy insurance they do not want and cannot afford.
4. Government should provide financial assistance to enable people to buy health care and health insurance; the amount should be the same for everyone at the same age and income level; and a comparable amount should be allocated even for people who elect to remain uninsured.
5. Government financial assistance should be neutral with respect to (1) the choice of individual or employer purchase of health insurance; (2) the choice of third-party insurance versus individual self-insurance by means of a Health Savings Account; and (3) the choice to insure or not insure.
6. Public and private risk adjustment should make the sick just as financially attractive as the healthy to health plans – unlike the current system which gives plans perverse incentives to attract the healthy and avoid the sick.
7. People who maintain continuous coverage should be able to renew their coverage or switch to other plans without financial penalty for a pre-existing condition.
8. In buying health care and health insurance, people should be able to reap the full benefits of competitive marketplace.
9. A fully funded safety net should meet any needs that are not met by the private sector.
10. The only remaining purpose of government is to ensure that a competitive market exists to meet patient needs at the highest level of quality and the lowest level of cost.
This seems like a very good plan in most respects.
I am particularly interested in item #9. I am a former actuary.
Let’s say that 20 million people choose a limited benefit plan that has a $50,000 limit on claims.
The safety net will have to pay any claims larger than that.
Just using rough numbers, the cost of that safety net could be $80 billion a year. Maybe it is half that, but a lot of money nonetheless.
I just want this to be acknowledged. During the ACA debates, some Republicans wanted to use high-risk pools instead of guaranteed issue. That’s fine, but the amounts proposed for those pools were ludicrously small. Don’t have this happen again.