Replacement Plan Proposal: Make Health Care Great Again Act of 2017

Avik-S.-A.-Roy_avatar_1467049054

Avik Roy wrote an excellent piece in Forbes taking on the issue of guaranteed issue head on:

Thanks To Democrats, Pre-Existing Conditions Outweigh The Uninsured In The GOP Obamacare Deal

Should we continue letting the “ludicrously dishonest” (well stated Avik Roy) presumptions of the ACA shape the future of our healthcare delivery system?

I think not.

Prior to the ACA, 6 states (Maine, Massachusetts, New Jersey, New York, Vermont and Washington) required guaranteed issue individual plans. In 2010 these states had some of the highest individual insurance rates in the country:

KFF 2010 Average Individual Premium Per Person

There were another 35 states that offered guaranteed issue high risk pools:  

High-Risk Pools For Uninsurable Individuals

That means 41 states already had access to guaranteed issue individual plans prior to the ACA. 

Here’s another point… around my part of the country (KS / MO) the guaranteed issue plans available prior to the ACA were less expensive than the non-subsidized 2017 individual plans! 

ACA proponents are quick to point out that there are more people insured now than prior to the ACA. What they fail to mention is that most of those gains are from new Medicaid enrollments (15 million) vs. state or federal Marketplaces (11 million):

Key Facts about the Uninsured Population

Since I don’t just want to be the one pointing out problems without offering a solution, here are my recommendations for an ACA replacement plan:

  • Repeal the ACA… All of it
  • Individual mandates and employer mandates would be gone (no more 1095-C forms… would anyone be disappointed?)
  • All individual health insurance premiums should be tax deductible just like employer group plans are tax deductible
  • States should decide if they want dependents covered through age 26
  • States should decide if they want to require all individual plans to be guaranteed issue
  • States that don’t require guaranteed issue should be required to have a high risk pool

Since government programs are the nearest thing to eternal life we’ll ever see on earth (Reagan / Byrnes), I am assuming subsidies are here to stay.

  • These high risk pools would be partially subsidized by states and the federal government to help make them affordable
  • Low income people would receive reduced tax credits / subsidies to purchase whichever health plans they want (no minimum essential coverage)

Keep in mind, the subsidies could be reduced (if not eliminated) for a lot of people when the cost of insurance goes back down.

  • States should decide if they want Medicaid expansion (and be willing to pay for it themselves)
  • Include tort reform legislation limiting frivolous lawsuits and capping malpractice settlements
  • Include Price Transparency legislation letting patients know up front what tests and procedures will cost

And since health insurance does not equal health care, there needs to be fundamental changes to physician access:

  • Direct Primary Care’s (DPC) monthly membership fees should be allowed as an eligible HSA / FSA expense (are you surprised I made it this far before mentioning HSA?)
  • States should be given block grants to explore more effective health care delivery systems (i.e. HSA & DPC) for Medicaid, Medicare, and VA

I think the replacement bill should be called… the “Make Health Care Great Again” Act.

Anyone willing to sponsor it?

ObamaCare is HERE!

ObamaCare Day 1

ObamaCare is here…
The healthcare landscape has changed.

Dave Ramsey's ELP

Dave Ramsey’s ELP

As Dave Ramsey’s Endorsed Local Provider (ELP), our goal is to make you aware of these changes.
We have tools available to help answer your questions:
You have more options available now than you will have next year.
MyObamaCareCalculator.com

MyObamaCareCalculator.com

For an individual / family PRE-OBAMACARE QUOTE, click on your state:

Alabama                             Montana
Alaska                                 Nebraska
Arizona                               Nevada
Arkansas                            New Hampshire
California                            New Jersey
Colorado                            New Mexico
Connecticut                        New York
Delaware                            North Carolina
Florida                                North Dakota
Georgia                              Ohio
Hawaii                                Oklahoma
Idaho                                  Oregon
Illinois                                  Pennsylvania
Indiana                                Rhode Island
Iowa                                   South Carolina
Kansas                                South Dakota
Kentucky                            Tennessee
Louisiana                            Texas
Maine                                 Utah
Maryland                            Vermont
Massachusetts                   Virginia
Michigan                             Washington
Minnesota                          West Virginia
Mississippi                          Wisconsin
Missouri                             Wyoming

Obama-Car

Obama-Car Volt

While talking about healthcare reform with my wife, our teenage son started asking questions. We tried to answer him in a way he could understand, but we just weren’t getting through. Health insurance is a foreign language to him. However he is dreaming about which car he will soon purchase. So we introduced ObamaCare to him by way of the Affordable Car Act… a.k.a. Obama-Car:

Obama says his reforms will include additional mandated essential health benefits AND reduce health insurance costs by $2500 per family. That’s simply impossible. That would be like requiring all 2014 cars to be either hybrid or fully electric (more energy efficient), include run-flat tires with electronic low-pressure warnings (better fuel economy), HID headlights (better night vision), GPS (less fuel wasted getting lost), and satellite radio (because it sounds good) at a lower price.

Yes, these OPTIONS are nice if you have the money to pay for them, but they should remain OPTIONS, not REQUIREMENTS.

Instead of a Chevy Cruze starting at $17,000 the new Obama-Car compliant version (such as the Chevy Volt) would be priced around $34,000.

Obama claims these new cars will only be paid in full by the “millionaires and billionaires” because anyone making less than 400% of the poverty level will have some (or all) of their car subsidized by the government.

Now let’s talk about used cars…

obama-car

Let’s say you like your existing car.  As long as you owned it before March 23, 2010, you would be allowed to keep it. You cannot make any changes to it or it would no longer be “grandfathered” and you would be forced into buying a new Obama-Car next year or pay a penalty.

If it doesn’t get good enough gas mileage or include all the new Obama-Car required Overpriced Bureaucratically Authorized Mandated Add-ons (OBAMA), then you would also be penalized.

Our son is glad Obama-Car doesn’t exist. He can save his own money to purchase any car he chooses… as long as Dad (not Obama) approves of it!

Dislaimer:  This article was never meant to suggest Obama-Car legislation is needed or should ever become law.

Prepare For ObamaCare

Dear Nancy Pelosi,

After 3+ years and 20,000+ pages of additional clarifications…
WE STILL DON’T UNDERSTAND WHAT’S IN IT!

Senate Minority Leader Mitch McConnell (R-KY) points up at ObamaCare
Senate Minority Leader Mitch McConnell (R-KY) points up at ObamaCare
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