September 25, 2020
A Vote for Choice and Competition –– Issue #100

President Trump delivered his long-awaited speech on health care yesterday in Charlotte, NC, outlining both his administration’s accomplishments—an impressive list—and his plans for future actions.

His America First Health Plan is organized around the theme of “Empowering Americans to choose what coverage works best for them and their families, not what bureaucrats force them into.”

Many of the accomplishments he described were developed under the guidance of Galen Senior Fellow Brian Blase when he served as one of the president’s top health policy advisers in the White House—especially rules around price transparency, association health plans, short-term policies, and potentially-transformative Health Reimbursement Arrangements.

HRAs create a next-generation option for employer health benefits, making them more like 401Ks for health benefits and are “projected by the Department of the Treasury to reach 800,000 businesses and over 11 million employees and to expand coverage to more than 800,000 individuals who would otherwise be uninsured,” the Executive Order says.

Other accomplishments that get little coverage: Expanding health savings accounts.  Improving the accessibility and availability of telehealth services. Improving the physical and communications healthcare infrastructure available to rural Americans. And more.

There is a big difference between the approach the president is taking that that of the left, explaining some of the criticism of his plan.  His agenda is mostly organized around identifying problems and targeting solutions—focusing on opioid abuse, making insulin more affordable for diabetics, and keeping premiums for Medicare plans and Part D drug coverage low. The administration’s actions also have led to a decrease in benchmark premiums for individual insurance in the ACA exchanges in 2019 after they more than doubled under the Obama administration.

All of this favors choice, competition, consumer empowerment, and innovation.

Perhaps the campaign can quicken around the contrast between the visions of the candidates. Former Vice President Joe Biden’s reform plan would lead to massive changes in the individual health insurance market, making it difficult or impossible for private plans to compete against his proposed government-run and taxpayer-funded health plan, the “public option.”

The president also focused on prescription drug prices, signaling it continues to be a top concern of voters as they head to the polls.  We are already on record about our problems with these policies that import price controls from abroad in various forms.  More analysis on these proposals to come…

Also, this week, the Health Policy Consensus Group released its letter outlining dozens of policy recommendations in our Health Care Choices plan organized around choice and competition to lower prices and give people many more options for care and coverage. Our goal: Personalized Care That Puts You and Your Doctor in Charge.

You will see many areas of agreement between the president’s plan and the policies we are supporting, including calling for codification of the new options the president has created through his rule-making authority.

Finally, the death of Supreme Court Justice Ruth Bader Ginsburg has intensified the focus on the upcoming Nov. 10 oral arguments about the latest challenge to the Affordable Care Act, with plaintiffs arguing that when Congress voided the individual mandate penalty, it took away the center pillar of the tent that Chief Justice John Roberts used in 2012 to rescue the bill.

The important point for the public is that it isn’t Obamacare or nothing.  There are many different scenarios for a court decision and any implementation would take years.  But the administration and Congress surely will provide a replacement and we will be ready to work with them to make it a better solution than the failed ACA.

The Health Care Choices plan the Consensus Group has been working on for two years is a robust alternative that will indeed give people more choices and will increase coverage by lowering costs, while doing a better job of caring for the vulnerable.  
As you can see from this week’s news, conservatives do have ideas and better ideas, I would argue, on health reform but they are targeted reforms aimed at specific problems, not the top-down, Washington-knows-best programs, competition-crushing policies we like the ACA. 
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