This is Part II of a series of posts to describe the new Republican healthcare plan proposed by Rep. Pete Sessions (R-TX) and Sen. Bill Cassidy (R-LA) called the Sessions Cassidy proposal. There are twelve key provisions of the plan as explained by Economist John C. Goodman. The first six were covered in Part I. Today I will discuss the other six.
- Tax Fairness at Work
Instead of the current system of taxation that gives tax subsidies to employer-provided insurance but not for those who purchase their insurance separately, this new plan will treat everyone the same. Everyone will get the same tax relief regardless where they obtain their health insurance. Employees will not be able to double dip, however. Other tax relief, such as the ability of an employer to purchase insurance with pre-tax dollars, will be clawed back or topped up to the tax credit amount.
At last people will be able to take their health insurance with them when they change employers just as they currently do with their 401K or pension plans. That means no loss of coverage every time you change jobs.
- Liberating Medicaid
Medicaid will be block-granted to the states for each of four Medicaid populations. Eventually the per capita amount from the federal government will equalize. Medicaid enrollees will have the option of leaving Medicaid, claiming the tax credit and purchasing private insurance.
- Liberating the Doctor-Patient Relationship
Doctors will now be allowed to form “direct pay” or “concierge” relationship with their patients without fear of being regulated as insurance companies. They will also be allowed to bill for phone or email consultations. This is a big step into the digital age of medicine. Moreover, patients will be able to pay for these services using funds from their HSAs.
- Liberating the Local Practice of Medicine
The Center for Medicare and Medicaid Services (CMS) will be able to lift national restrictions on doctor-owned hospitals, clinics, and other facilities; state and local restrictions on walk-in clinics, free standing surgical centers and other market-based services. This should improve quality of care and lower prices through competition.
To minimize potential disruption, self-insured employer plans and labor union plans may elect to remain in the current tax system. Also, individuals with insurance obtained from an ObamaCare exchange may elect to remain in that system.
These twelve provisions of the Sessions Cassidy proposal go a long way toward solving the numerous problems of ObamaCare. It is a plan that should receive enthusiastic support in Congress if a Republican president is elected.