Why Haley’s health plan gives her an edge over Trump
The opportunity for a serious Trump alternative to achieve breakout momentum before the Iowa caucuses in January is rapidly closing in.
Nikki Haley has earned high marks for her intellect, candor, and practicality, but she cannot win without cutting into Trump’s base or expanding the Republican electorate.
She should make a bold play to change the conversation by emphasizing health care affordability, a non-traditional topic that could help her win over the populist base of her party and beat Biden in November.
Health insurance premiums and claims are soaring
Although the cost of health care rarely ranks as a top concern for conservative voters, it is a hole in the pocket of the working class that impacts all the other top issues. Health care is an inflation issue: Between 2002 and 2022, the median household income rose by $8,800 while the average family health insurance premium surged from $13,200 to $22,500, stunting middle-class wage growth, according to the U.S. Bureau of Labor Statistics.
Health care is also a crime issue: Linn County (the second largest county in Iowa) pays $20,900 annually in medical claims for every enrollee, essentially defunding police salaries and exacerbating the law enforcement shortage.
Finally, health care is an education issue: Des Moines Public Schools spend $19,900 a year on medical claims for every enrollee, money that could be spent attracting top teachers with better wages.
When health insurance is considered a right, health insurance corporations have a right to workers’ wages. Unlike free market competition, the health insurance cartel doesn’t lose customers due to bad plans because Obamacare mandates that everyone buy one, subsidizes those who can’t, and penalizes those who won’t.
(Editor’s note: While the individual mandate is still in effect, Congress did away with the penalty through the Tax Cuts and Jobs Act of 2017).
Big insurance companies love public relations stunts like Biden’s $35 out-ofpocket cap on insulin because they still get to gouge premiums instead. They also don’t mind that Obamacare requires them to spend 80%-85% of their revenue on claims because they simply pay out higher prices for prescriptions and procedures to keep their profits flowing.
Even people with health insurance have medical debt
Obamacare promised lower costs and increased access but delivered the opposite. Since then, insurance premiums and deductibles have almost doubled, according to the Kaiser Family Foundation, and 27% of Americans now put off treating serious conditions, up from 17% previously. In fact, more than 1 out of 5 Americans have both health insurance and medical debt.
Yet insurance corporations have profited extravagantly: Unitedhealthcare stock has soared from $33 before Obamacare to over $500 today. No wonder the medical industrial complex disproportionately funds Democrats who pad their pockets.
Nikki Haley’s PAC has proposed allowing employers to put the money they spend on insurance into health savings accounts. Workers could use that money to shop around for more affordable insurance options, sparking meaningful competition and putting real downward pressure on premiums. They would not lose their doctor and health insurance when they switch jobs. They would also have cash to pay deductibles and could save the rest for retirement. People will never control their health care without controlling their health care dollars.
Haley should own the health care issue because it bolsters her narrative that Donald Trump is a loser. With it, she can channel the populist current of the Republican base that is skeptical of corporate elites who enrich themselves by impoverishing everyone else.
Her classic conservative convictions are the solution to their anxieties, and her positive approach to health care would return four times as much wealth to working families as the Trump tax cuts did. Democrats understand that the majority of voters worry about health care and are betting big on it to win swing voters. Nikki Haley should, too.
Micah Moughon received a MBA with a health care concentration from Vanderbilt University, and his professional career spans nonprofit health care firms, large health insurance corporations, and small primary care companies.