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?

N. Scott Borden on Planning To Prosper 10-15-13

I was a guest on Andrew Scianna’s talk radio show this morning:

We discussed the disastrous first two weeks of ObamaCare and how many physicians are choosing to go Direct Pay.

Here is the Jon Stewart interview with Kathleen Sebelius we shared at the beginning of the interview:

For up-to-date ObamaCare information and calculators visit www.MyObamaCareCalculator.com

MyObamaCareCalculator.com

MyObamaCareCalculator.com

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

ObamaCare Calculators

MyObamaCareCalculator.com

MyObamaCareCalculator.com

Yes, the Affordable Care Act (ObamaCare) is upon us. As of now (August 2013) there are still way more questions than answers.

Should I keep my existing plan or get a new EXCHANGE plan?

Should employees & their dependents remain on employer group plan or get their own individual policy?

Will I qualify for a subsidy?

We have assembled several calculators available today that can help make preparing for 2014 much easier.

Although the employer mandate has been postponed until 2015, the individual mandate still applies.  Anyone not covered by Minimum Essential Coverage next year could be subject to a penalty tax of the greater of $95 per uninsured or 1% of household over the filing threshold:

INDIVIDUAL PENALTY TAX CALCULATOR

All new health insurance plans will be guaranteed issue and required to include essential health benefits which will greatly increase premiums.  The Public Exchanges (both state and federal) are to be open in October.  People making less than 400% of poverty level could be eligible for subsidized health insurance plans if they are purchased on the State / Federal Exchanges. It is estimated that 26 million should be eligible for these subsidies, however only 6 million are estimated to enroll in 2014. Here is a calculator to see if you would be eligible for a subsidy:

INDIVIDUAL / FAMILY SUBSIDY CALCULATOR

Small businesses with less than 25 employees that earn less than $50,000 average annual salary and pay at least 50% of their health insurance premiums could also qualify for a small business tax credit.  For 2014 the tax credit is only available if the plan is purchased through the Small Business Health Options Program (SHOP) Marketplace:

SMALL BUSINESS HEALTH INSURANCE TAX CREDIT CALCULATOR

Don’t wait until it’s too late.  If you are relatively healthy, you could save money by applying now BEFORE all plans are guaranteed issue and are weighed down with expensive government mandated benefits next year.

INSTANT ONLINE HEALTH INSURANCE QUOTE

Or you can call an independent health insurance agent at 913-432-2732.

Although the employer mandate has been delayed 12 months, businesses are still concerned about how to minimize (or eliminate) their exposure in 2015. This calculator helps calculate how many full time equivalent (FTE) employees you have and what your potential penalty might be if/when the employer mandate is reinstated:

EMPLOYER MANDATE CALCULATOR

And finally, for those of you with seven minutes to spare, here are the YouToons simplifying ObamaCare:

  • HSA Contribution Calculator