Healthcare reform is necessary to provide all Americans with the opportunity to choose a health insurance plan that meets their individual needs at a reasonable cost. Recent Gallup polling indicates that most Americans want healthcare systems with better coverage, access and quality.
This article presents an analysis of several possible pathways for achieving those goals. The first option improves the ACA’s current marketplace subsidies for premiums and cost-sharing and introduces a reinsurance program to protect insurers against very high claims. It also restores the ACA’s individual mandate penalty and reverses the Trump administration’s expansion of short-term, limited-duration plans. It also closes the Medicaid eligibility gap for people with very low incomes in states that have not expanded their programs and introduces a limited autoenrollment mechanism for TANF and SNAP enrollees. Federal government spending increases modestly under this option compared to current law because of the higher enrollment in subsidized marketplace plans.
The second option focuses on curbing excessive medical costs by limiting the amount of money that medical providers are paid for each procedure they perform (called “fee-for-service”). It’s important to note that doctors have a financial incentive to do more procedures and tests which generate higher revenues, but which often do not benefit their patients in the long run. This system is widely criticized by patient advocacy groups and other experts who believe that it encourages unnecessary and often risky medical interventions which ultimately increase health care costs.
About the Author
