A Health Care Solution for All Americans
Democrats and many media outlets are claiming that Republicans do not have a health care plan. This is unequivocally false. We have a solution, a bill with more than 500 pages of legislative text introduced in both the House of Representatives and the U.S. Senate. The Fair Care Act of 2020 (FCA) is based on years of research and provides answers to some of the most pressing health care concerns facing the nation.
At its core, the bill is simple. It would expand affordable coverage options for Americans and protect those who are most vulnerable, including those with preexisting conditions. The FCA would also redirect the enormous amount of resources currently flowing through insurance companies, employers, and the government to instead run through the patient, giving Americans the power to regain their sovereignty as health care consumers. Finally, the FCA would infuse the health care system with transparency, competition and innovation so individuals can shape a health care system that meets their needs.
You don’t have to look far to see the way Congress approaches health care reform is broken. Fixing the system requires bipartisan action. The previous administration left us with a failed and broken Affordable Care Act (ACA) — highlighted by its complex mandates, dysfunctional economic incentives and administrative bureaucracy — leaving most Americans crushed by rising premiums and reduced benefits. During his tenure, President Donald Trump has delivered a series of significant health reforms intended to fix the dysfunctional and expensive system.
Now it’s time for Congress to act. Here’s how.
First, the FCA provides more protections for those with preexisting conditions than the ACA while simultaneously expanding affordable coverage options. We recognize the importance of guaranteed issue, essential health benefits, dependent child coverage, and a ban on annual or lifetime benefit limits. However, requiring that insurers offer coverage at the same rate to all individuals regardless of their health status (as currently dictated by the ACA) hasn’t worked and has instead priced millions of Americans out of the health care system. The Fair Care Act reintroduces all the ACA’s protections, extends guaranteed issue to Medigap plans, and establishes a national invisible high-risk pool reinsurance program that directly subsidizes coverage for those with preexisting conditions. This guaranteed coverage risk pool would also increase subsidy assistance from current ACA levels (400 percent Federal Poverty Level) to 600 percent of the Federal Poverty Level and implement more low-cost coverage options. These combined policies will increase individual market enrollment, promote insurer competition, and lower premiums for all.
In addition to strengthening the individual marketplace, the FCA reforms our employer-based health care system by giving employers and employees more options to pay for and purchase coverage. For example, employers could still offer coverage under the FCA, but they could also fund tax-advantaged individual accounts for their employees. This would give employees the resources to pay for coverage that’s not tied to their employment in an affordable individual marketplace.
Too many Americans have lost their power to be health care consumers because they lack adequate health savings. How can this be when the average American spends more than $11,000 a year on health care? It’s because about 90 percent of every health care dollar is spent by a third party, not actual consumers. We need to put more of this money into the hands of individuals and families instead of funneling it through insurance companies, employers and the government. The FCA does just that, eliminating the employer mandate to offer health insurance but allowing those with employer coverage to opt out and still receive premium assistance in the marketplace. It also consolidates tax-advantaged health expense savings accounts into one simple Medisave account. These accounts would be available to those with private insurance, Medicare or Medicaid, are owned by the individual, and can be used towards the purchase of health plan premiums and any qualified medical expense. These patient-driven changes will result in a health care industry that meets the needs of consumers by competing on price, quality and service, just like any other industry.
Finally, the FCA will promote transparency and competition throughout our health care system. Our health care system will never function properly unless it is accountable to consumers and their needs. The only way to do this is to empower consumers and ensure a system with real prices and quality signals. Making pricing and quality information easily available to health care consumers will drive innovation, promote competition and ultimately lower the cost of health care for everyone.
The U.S. spends more than twice as much as other countries on health services. The FCA addresses this problem by codifying the Trump administration’s rules on health care transparency, establishing a national all-payer claims database (APCD) and discouraging hospital competition in non-rural areas. Our bill also builds on bipartisan drug reform policy to modernize the approval process, bring safe and effective medicine to patients faster, promote generic drug approval and provide more oversight on cost-increasing middlemen like Pharmacy Benefit Managers.
Democrats who say we need to protect those who are most vulnerable and enable them to easily obtain affordable health coverage are right. We should have a system that ensures coverage is affordable, and no one goes broke as a result of a bad accident or diagnosis. Republicans who say that we need a health care system that is driven by market forces are also correct. These ideas are not mutually exclusive. In fact, they support each other and must happen at the same time to fix our current health care system. Both political parties can agree that our health care system is in desperate need of repair. FCA is the proactive, creative solution we need. We designed each of these provisions with one group in mind: the patient. Health care has too long been a politically charged issue, but FCA builds on bipartisan, bicameral reforms to put us all on the same team. Let’s get started.
Sen. Mike Braun (R) is the junior United States senator from Indiana. Rep. Bruce Westerman (R) represents Arkansas’ 4th congressional district.