The ObamaCare Replacement Plan – Part IV


In Part I of this post I described in general terms the Republican plan to replace ObamaCare as put forth in a bill sponsored by Rep. Pete Sessions and Sen. Bill Cassidy known as the Sessions-Cassidy plan. In Part II I discussed how this plan improves over ObamaCare. In Part III I listed the first six of twelve ideas in the Sessions-Cassidy plan that make this plan a great replacement for ObamaCare. Today I will list the second six of those twelve ideas.

Twelve Ideas For Better Healthcare (continued)

  1. 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.

  1. Portability

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.

  1. 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.

  1. 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.

  1. 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. This gives people options – unlike ObamaCare – where they can actually keep their plan if they like it or switch to a better plan as most will do when they realize the ways in which the Sessions-Cassidy plan improves their healthcare and lowers its cost.

Having studied the various plans of Republicans proposed over the last seven years, I agree with economist John C. Goodman that the Sessions-Cassidy plan is the best replacement plan for ObamaCare. The only good thing about the ObamaCare train wreck is that it gave us the impetus to debate and research better ways of providing healthcare. As a result we now have a plan that can greatly improve on ObamaCare and the healthcare system that preceded it. It is a plan that should receive enthusiastic support in Congress now that we have a Republican president.

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