Jul 28, 2017

Failure to Repeal Obamacare is Disappointing, But the Effort to Improve Health Care Must Continue

Post by Geoff Holtzman

Arlington, VA — Freedom Partners Vice President of Policy Nathan Nascimento issued the following statement regarding the Senate’s vote earlier this morning on Obamacare legislation:

“It’s deeply disappointing and disheartening that senators who promised for years to provide relief from the devastating impacts of Obamacare failed to keep that promise this week. But improving health care is far too important to simply move on from, and we urge Congress to stay focused on delivering the repeal and reform Americans deserve.


“In addition to legislation, there are several actions the Trump administration and Congress should take right now to help ease Obamacare’s burden on millions of hardworking Americans, increase access to health care, especially for those most in need, and give patients more control. We remain committed to working with both Congress and the administration to reduce costs and increase access to quality care by fully repealing Obamacare and passing long-term reforms that address fundamental problems with health care.”

BACKGROUND: What the Administration and Congress Should Do as Repeal Efforts Continue

During the debate over the American Health Care Act (AHCA) earlier this year, members of Congress and the Trump Administration indicated that the bill was just the first of three phases to repeal Obamacare and reform our health care system.

According to the U.S. Department of Health and Human Services (HHS), the second of those phases would come in the form of “administrative actions that will create a healthier insurance market and alleviate the burden the current healthcare law imposed on Americans.”

Meanwhile, House Speaker Paul Ryan signaled that the third phase would consist of “[additional] legislative policies, such as allowing individuals to purchase coverage across state lines, that by Senate rules cannot be included in a reconciliation bill.”

“Phase II”

As Congress continues working to repeal Obamacare, there are several “Phase II” actions that HHS can take right now that don’t depend on, and should not wait for, final passage of a bill. These actions, which Freedom Partners and Americans for Prosperity highlighted in a letter last month to HHS Secretary Tom Price, include:

  • Loosening Obamacare’s Choice-Stifling Coverage Mandates. These mandates, as defined in Section 1302(b)(1) of Obamacare, deprive patients of choice when it comes to the types of benefits they need and want. Loosening these mandates would drive down the cost of insurance and would give millions of Americans the freedom and flexibility to choose the type of coverage that truly meets their unique needs.


  • Offering States More Flexibility from Obamacare’s Regulations. Building on HHS’ initial efforts to make it easier for states to apply for 1332 waivers from certain cost-increasing Obamacare requirements, the department should expand the list of regulations that states may choose to opt out of. This would create new and more affordable plan options for patients who are struggling with Obamacare’s higher costs and fewer choices.


  • Undoing Regulations That Limit Short-Term Insurance Plans to Three Months. Short-term insurance plans are affordable solutions for those who are either in between coverage options, traveling out-of-network, or looking to fill gaps in their primary coverage. Undoing Obamacare’s restrictions on these plans would create more affordable options and provide Americans with more choices in the type of coverage they are able to select.


  • Relaxing Obamacare’s Minimum Actuarial Value Rule. By forcing insurers to pay for a higher percentage of covered services, Obamacare’s Minimum Actuarial Value Requirement eliminates more affordable plans and drives up prices. A recent Heritage Foundation report estimated that this requirement “increased the cost of the least expensive plans by an average of 8 percent.” Relaxing this rule through previous rulemaking was a good improvement, and further action would provide relief to Americans in the form of more affordable options.

“Phase III”

Congress should proceed without further delay on “Phase III” reforms that may include the following targeted solutions that Freedom Partners highlighted in a strategy memo earlier this year.

  • Giving Patients More Control of Their Health Care by Expanding Pre-Tax Health Savings Accounts. This would include increasing Health Savings Account contribution caps and allowing patients to use this money to pay for insurance premiums and direct primary care physician membership fees. Currently, only 10 percent of health spending comes from patients, themselves, which means the vast majority of decisions are made in which a third (or fourth) party is paying the cost. This takes control out of the hands of individuals and families and gives it to insurance companies and hospitals, which negotiate directly with each other to determine acceptable courses of treatment for various conditions, and their corresponding reimbursement rates. This results in higher costs for services with little to no accountability for outcomes and care. Expanding Health Savings Accounts to allow people to pay for health care needs with pre-tax savings will put patients back in control, rather than be subject to what insurance companies or the government approves.


  • Increasing Access to Health Care by Raising or Lifting Limits on the Number of Annual Medical Residencies. Congress currently sets limits on the number of medical residencies available nationwide. This may explain why, as recently as a few years ago, the United States had fewer primary care physicians per capita than any other industrialized country. This doctor shortage hits Americans in rural areas particularly hard. Congress can help patients gain access to health care by increasing or lifting limits on the number of annual residencies available.


  • Helping Terminally Ill Patients Receive Faster Access to Potentially Life-Saving Drugs and Treatments by Passing National Right to Try Legislation. Right-to-try laws are aimed at giving patients with terminal diseases access to promising new treatments that are being safely used in clinical trials, but are not yet available on pharmacy shelves. These laws also protect doctors and their institutions from the legal ramifications stemming from prescribing therapies that are not yet FDA-approved to patients with no alternatives. To date, 37 states have passed right-to-try laws, and President Trump’s administration has expressed support for legislation at the national level. Bureaucrats should not be allowed to come between a doctor and a patient and prevent a chance at life – Congress should take up this measure immediately.