The King v. Burwell decision will arrive soon. The future of ObamaCare hangs in the balance. There are days when the court decision appears to be a subject of intrigue and other days when it is a subject of dread. President Obama seems to have no Plan B while the Republican-led Congress continues to bring forward ideas. It is fair to say that the Democrats and this administration have made a mess of health insurance and health care delivery.
The defenders of ObamaCare are touting a reduction in the uninsured rate as a marker for success. Unfortunately, that is all ObamaCare has accomplished – increased numbers of people with insurance cards. As we have consistently said, this is a poor surrogate for actual access to health care. Health insurance and delivery of health care are two separate activities.
We continue to hear from our constituents about high co-pays, high deductibles, and skyrocketing insurance premiums under this program. Constituents say enormous out of pocket expenses present a barrier to health care. If you can’t afford your co-pay, deductible, or premium your insurance card is worthless.
I was recently stopped in the grocery store by a single mom with 3 children and she told me her policy was simply too expensive to use. She felt she was the victim of false hopes.
The Supreme Court decision in King v Burwell will provide us with the opportunity to undo the damage of the past 5 years and reset the health care button. The court will set the date for the subsidies to end. At that point, they must end and must not be renewed.
There is a conservative way forward which will incorporate two overarching, strategic ideas. We begin with the end in mind – access to affordable health care for all Americans.
First, with increased access to affordable health care for all Americans as our mantra, we will reform the health care system. It is crucial to understand that actual access to affordable health care is different than eligibility for an overly prescriptive, Washington-driven, health insurance policy.
Secondly, once the Supreme Court determines the ObamaCare subsidies to be illegal, they must stop. They represent the most disingenuous part of law – they are a broken promise to Americans looking for affordable health care.
Once again, if you can’t afford your co-pay, deductible, or insurance premium, your subsidy and insurance cards are worthless.
Further, these subsidies are an irresponsible, wishful thinking, use of taxpayer dollars. The American people expect us to end them at the very moment the Court deems them to end. At that point, ObamaCare will cease to exist.
Next we move to the tactics of implementing our strategy to increase access to affordable health care for all Americans. We do not want anyone to be left in the lurch due to having been a part of the ill-conceived exchanges.
Reaching our goal will require significant changes in our ways of thinking about the infrastructure and use of health care. The fatal flaw of ObamaCare is that it simply built a system on what was already crumbling.
To achieve transformation, all voices must be heard – patients, doctors, payors, hospitals, and others. Transformation will never be accomplished behind closed doors in Washington. Washington should create the environment and transformation will be accomplished in health care innovation centers around the country.
Legislative changes will need to be made. These will be done in a systematic, thoughtful, and deliberative manner and meet the date the court sets to end the subsidies. Some changes will not be easy, but they will be necessary. Choices made will be done in a pragmatic manner.
We’ve discussed an overarching strategy of increasing access to affordable health care for all Americans. We’ve also discussed the deliberative process by which we will accomplish the tactical implementation of true healthcare reform.
Finally, we will focus on specific ideas to implement. Many of these ideas are already included in GOP sponsored legislation – they are on the shelf, ready to go. For the past several years, these ideas have been the subject of hearings, discussions, task force efforts and have been found worthy of consideration.
Patient-focused reforms will include protection from old practices which allowed insurance companies to refuse to insure because of pre-existing conditions. Lifetime limits on health care would no longer be allowed, nor would rescissions of coverage. All efforts would be made with the idea of making health care affordable for the individual and providing bankruptcy protection which was problematic in the past.
Small businesses and individuals will be empowered by having the ability to choose from a wide variety of insurance products such as health savings accounts. This is in stark contrast to Obamacare which is a mandated, one size fits all idea.
A standard tax deduction for health insurance will make the tax code fairer for those who work for small companies or who are self employed. Currently, many of those individuals are purchasing insurance with post-tax dollars. All would benefit from the tax advantage that employees of large companies enjoy.
A more competitive insurance market will be encouraged by allowing the purchase of health insurance across state lines as well as the enforcement of antitrust measures with insurance companies.
States will be empowered to provide coverage for their most vulnerable citizens by increasing the roll of State high risk pools and modernizing Medicaid.
And costs in health care will be addressed. Discouraging overutilization of services, misutilization of the emergency room and decreasing the need for defensive medicine will all help with costs.
Finally, in this process it is helpful to remember the wise words of Lao Tzu, “The journey of 1,000 miles begins with one step.”
In the case of achieving meaningful increased access to healthcare, it begins with the end of the ObamaCare subsidies.
Rep. Marsha Blackburn is a member of the U.S. House of Representatives serving the Seventh Congressional District of Tennessee. She serves as vice chair of the House Energy and Commerce Committee and is a member of the House Budget Committee.