The GOP’s Oba­macare wish list

The Denver Post - - OPINION - By Doug Lam­born Re-ad­just age-rat­ing ra­tios. Make HSAs avail­able to all. Pro­mote in­sur­ance pool­ing. Re­form med­i­cal li­a­bil­ity. Pro­tect con­science rights.

Many Amer­i­cans are ques­tion­ing the fu­ture of Oba­macare af­ter the elec­tion of Don­ald Trump. Pres­i­dent-elect Trump made it clear dur­ing his cam­paign that one of his top pri­or­i­ties is to re­peal and re­place the ill-fated law. The mes­sage clearly res­onated with many vot­ers.

So where do we go from here? Repub­li­cans are co­a­lesc­ing around Speaker Paul Ryan’s Bet­ter Way plan for health care re­form, a pru­dent and prac­ti­cal plan that will re­vive our health care sys­tem, put pa­tients first, and pro­vide ac­cess to qual­ity cov­er­age and care for all Amer­i­cans.

Over­all, Oba­macare has been un­pop­u­lar, ex­pen­sive, and un­work­able. How­ever, some in­di­vid­ual por­tions of the law are sup­ported by Amer­i­cans. Repub­li­cans will un­doubt­edly in­cor­po­rate these pop­u­lar as­pects into the next gen­er­a­tion of health care. These poli­cies will: al­low chil­dren to stay on their par­ents’ in­sur­ance plan un­til age 26, pro­hibit life­time lim­its on in­sur­ance cov­er­age, pro­tect those who suf­fer from pre-ex­ist­ing con­di­tions, in­cen­tivize, though not man­date, em­ploy­ers to of­fer health care cov­er­age, and make re­fund­able tax cred­its avail­able.

Here are some of con­crete ideas to re­duce reg­u­la­tions and man­dates while pro­mot­ing con­sumer choice. Un­der Oba­macare, the ra­tio was moved from a five-to-one ra­tio to a three-to-one ra­tio, mean­ing that an older per­son’s in­sur­ance pre­mium could not cost more than three times that of a younger per­son’s pre­mium. This has had the dual ef­fect of bring­ing older, sicker in­di­vid­u­als into in­sur­ance pools while in­creas­ing costs on younger in­di­vid­u­als. Many younger en­rollees de­cided to sim­ply leave the mar­ket rather than sub­si­diz­ing older and sicker en­rollees, which has cre­ated short­ages. Health sav­ings ac­counts (HSAs)are tax-ad­van­taged sav­ing ac­counts where funds can only be used to help pay for health care ex­penses. HSAs in­cen­tivize good stew­ard­ship of how the money is used be­cause any un­used funds at the end of a year are rolled into the next year. They also pro­mote com­pe­ti­tion within the mar­ket. Many small busi­nesses would like to of­fer their em­ploy­ees health in­sur­ance, but are un­able to do so be­cause of costs. Un­der the GOP al­ter­na­tive, small busi­nesses could pool their re­sources even across state lines to of­fer as­so­ci­a­tion health plans. If la­bor unions and cor­po­ra­tions can al­ready do this, it’s only fair that Amer­ica’s small busi­nesses be al­lowed the same ben­e­fit. Doc­tors shouldn’t be forced out of busi­ness be­cause of friv­o­lous law­suits, nor should health care fa­cil­i­ties be shut down over lit­i­ga­tion. With­out sub­stan­tive med­i­cal li­a­bil­ity re­form, our health care sec­tor will con­tinue to face in­creased costs, which in turn will in­crease the price of other health care ser­vices. We need to em­power the states to take the lead in im­ple­ment­ing much­needed re­forms that ad­dress real griev­ances while re­duc­ing the cost of de­fen­sive medicines. Amer­i­cans should be al­lowed to con­duct their lives in ac­cor­dance

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