Healthcare Reform Principles That Cross Party Lines

 

Can both parties agree on anything in healthcare reform?

That was the question put to the test in a rare conversation between supporters and opponents of ObamaCare.

Lanhee J. Chen, fellow at the conservative Hoover Institute of Stanford University, and Ron Pollack, founding executive director of Families USA, writing in The Wall Street Journal summarized this rare meeting of conservative and liberal thinkers. Joining in the conversation were Sara Rosenbaum, Gail Wilensky, Joe Antos, John McDonough, Grace-Marie Turner and Stuart Butler – a group of health policy researchers who hold diverse political views and policy outlooks.

Principles They Agreed Upon

In the privacy of a conversation apart from the hysteria of media microphones and television cameras, this diverse group was able to elucidate those principles they agree should form the basis of healthcare reform. Here are the points they agreed should be present in any reform legislation:

  • Public subsidies for private insurance premiums should be means tested This ensures that coverage will be more affordable for low-income people.
  • States should be given flexibility to streamline coverage options in Medicaid, CHIP, and other publicly supported insurance – This is to ensure that families can obtain the coverage that best suits their circumstances and serves their needs.
  • The existing tax exclusion for employer-sponsored health benefits should have reasonable limits
  • Subsidies should be provided for people who need help to purchase adequate insurance
  • States should be given waivers to reform Medicaid to develop fiscally sound and affordable coverage options.
  • States should be given greater authority to configure and redirect revenue streams from Medicaid, CHIP and private insurance to improve and strengthen coverage. Integration of funding streams would make it easier for individuals to keep the same coverage and providers when their employment or life circumstances change. Experimentation by the states would enable states to better serve the needs of their citizens.
  • Federal budget neutrality – Neutrality should be required for the cumulative budget impact of a proposal by the states.
  • State flexibility should not allow funds for healthcare services to be diverted to other purposes.

 

How well does the new Senate healthcare reform bill adhere to these principles?

The Better Care and Reconciliation Act of 2017 (BCRA) was just released by the Senate. Let’s see how well it stacks up with these bi-partisan principles:

  • Public subsidies for private insurance premiums should be means tested The BCRA tax credits are means tested
  • States should be given flexibility to streamline coverage options in Medicaid, CHIP, and other publicly supported insurance – The BCRA gives states flexibility to develop their own Medicaid programs.
  • The existing tax exclusion for employer-sponsored health benefits should have reasonable limits – The BCRA maintains the “Cadillac tax” of ObamaCare that places limits on the employer tax exclusion.
  • Subsidies should be provided for people who need help to purchase adequate insurance – The BCRA provides this through means tested tax credits
  • States should be given waivers to reform Medicaid to develop fiscally sound and affordable coverage options – The BCRA eliminates the need for waivers, giving states the flexibility to reform Medicaid to their needs
  • States should be given greater authority to configure and redirect revenue streams from Medicaid, CHIP and private insurance to improve and strengthen coverage – The BCRA does this within the confines of long term per-capita caps
  • Federal budget neutrality – The BCRA places caps on Medicaid spending, eliminating the open-ended Medicaid entitlement of ObamaCare.
  • State flexibility should not allow funds for healthcare services to be diverted to other purposes – The BCRA includes this.

 

Therefore, the BCRA includes all eight recommended principles of this bi-partisan group of healthcare researchers. While both sides would prefer other changes or retained portions of ObamaCare, on these eight principles they agreed were essential, the BCRA includes every one!

This discussion makes it clear that there is bi-partisan agreement among healthcare researchers on the principles most needed in a new healthcare legislation.

If partisan politics could be put aside in the interest of the healthcare of the American people, both parties should be happy to vote for The Better Care and Reconciliation Act of 2017! What more can you hope for?

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