Price’s Obamacare fix will likely cause harm

I am a moderate Republican, but I cannot support U.S. Rep. Tom Price, R-Roswell, as the nominee to be Secretary of the U.S. Department of Health and Human Services (DHHS).

There have always been arch-conservatives in Georgia who would do anything to win. But, with the election of Jimmy Carter as governor, that situation began changing for the better. Georgians were becoming more open to progress.

Across the last decade or so, Georgia has elected GOP legislators much to the right of their predecessors. Among them is Rep. Price. Incapable of getting bipartisan legislation through Congress, Price is also against many government programs, including family planning and the Affordable Care Act (Obamacare).

Price and Speaker Paul Ryan are the health policy leaders in the House. Both want to “reform” health care by eliminating Medicare and Medicaid. But, because both programs are very popular with taxpayers, elimination is not the term they use. Instead, they use code words like modernize/privatize (i.e. vouchers versus defined benefits) and block grants to states.

There are only four ways to bring down these expenditures: a.) cut the number of people served; b.) reduce the benefits each person gets; c.) slash provider/drug reimbursement; or d.) increase efficiency.

The Price and Ryan proposals obtain cost savings via “a” and “b”. Little wonder the Price nomination is supported by provider and insurance special interests that dislike “c’’ and “d”.

Medicare overhead is 3 percent, whereas private plans run up to 20 percent. There is no fiscal justification for gutting the existing program, just an ideological one.

Vouchers do away with Medicare as we know it. Seniors, the sickest group of Americans, are thrown to the wolves, searching for nonexistent affordable private plans that cover pre-existing conditions or going into unaffordable high-risk pools.

Medicaid block grants, capping expenditures, are essentially just an overly simplistic budgetary tool. Can you imagine the result if we established an arbitrary cap for our military and homeland security budgets each year, regardless of need?

Yes, you can control expenditures this way, but not without dire consequences to beneficiaries. A 2012 Kaiser Family Foundation report analyzed the impact of Medicaid block grants and ACA repeal. It found that half of all Medicaid recipients would lose coverage — 37.5 million Americans. State spending would have to increase by 77 percent to keep these people covered with spending growth held constant, Kaiser found. Even if Medicaid inflationary growth were reduced to the GNP growth rate (which would mean cutting recipients, benefits to recipients, or reimbursement to providers), states would still have to increase spending 46 percent to avoid coverage cuts. Poor people would again be thrown to the wolves when states inevitably refuse to blow up their budgets.

As for the ACA, Price’s reform bill (HB 2300) is a mishmash of unproven conservative theories, including tax credits, HSAs (health savings accounts), malpractice reform, risk pools and group insurance purchasing. While some of these ideas may have individual merit, they do not replace the ACA, which covers more than 22 million people.

The 2016 health insurance premium for a family averages $18,142, Kaiser reported. The HB 2300 maximum tax credit is $3,000, clearly not enough of an incentive to buy insurance versus substantial existing ACA subsidies. Plus, Price’s bill does not even address two popular ACA provisions President-elect Donald Trump has vowed to keep: keeping folks on their parent’s insurance provisions until they reach age 26, and prohibiting exclusions due to pre-existing conditions. As U.S. Sen. Charles Schumer, D-N.Y., told Fox News, “You can’t keep the good things without keeping ACA.”

Trump has stated that, in an ideal world, the Canadian system is the best way to go, and Obama agrees. Imagine what would have happened if Trump had nominated someone who advocated expanding Medicare. With bipartisan support, single-payer could be a reality, saving money while ensuring access for every American. Canadian per capita cost is just $4,506, versus $9,024 in the U.S.

Appointing an ideologue like Price simply brings partisan baggage to DHHS.