Tuesday, December 31, 2013

Market Freeing Tweaks to Obamacare

This is from Jonathan Weismann at the New York Times

... [Obamacare opponents] are considering several ideas for how to proceed. [Senator Ron] Johnson argued that 

  • Congress should do away with the mandate that most people obtain insurance, but not the online exchanges at the heart of the law. Instead, he said, 
  • the options in the marketplaces should be augmented by other choices that fall short of the law’s coverage standards, such as catastrophic health plans. ...

“The hardest problem for us is what to do next,” [Senator Lindsay] Graham said. “Should we just get out of the way and point out horror stories? Should we come up with a mini Contract With America on health care, or just say generally if you give us the Congress, the House and the Senate in 2014, here’s what we will do for you on multiple issues including health care? You become a more effective critic when you say, ‘Here’s what I’m for,’ and we’re not there yet. So there’s our struggle.”

Senator Kelly Ayotte, Republican of New Hampshire, said she was teaming up with Democrats on a host of incremental changes to the law, such as 

  • expanding health savings accounts and 
  • repealing a tax on medical devices. ...

Representative Tom Price, Republican of Georgia, a physician and a prominent conservative voice on health care, is pushing what he calls the Empowering Patients First Act, which would 

  • repeal the health care law but keep its prohibition on exclusions for pre-existing conditions in private health insurance.  The bill would 
  • allow for insurance to be sold across state lines, 
  • push small businesses to pool together to buy insurance for their employees, 
  • expand tax-free health savings accounts, 
  • cap malpractice lawsuits, and 
  • offer tax credits of $2,163 for individuals and $5,799 for families to buy health plans.

The American Action Forum, a conservative advocacy group run by Douglas Holtz Eakin, a former director of the Congressional Budget Office, analyzed the Price plan this month. The group concluded that it would lower insurance premiums by as much as 19 percent by 2023, while leaving the ranks of the uninsured about five percentage points higher than the Affordable Care Act would by then.

Representative Paul D. Ryan of Wisconsin, the Republican vice-presidential nominee in 2012 and a possible 2016 presidential hopeful, is preparing his own health insurance plan for release early next year.

Mr. Ryan’s plan will build on one that he and Senator Tom Coburn, Republican of Oklahoma, introduced in 2009, according to aides familiar with it. The proposal, called the Patients’ Choice Act, would have 

  • eliminated the tax break for employer-provided health care to finance 
  • a tax credit of about $5,700 for families and $2,300 for individuals. 
  • States would have been asked to create insurance marketplaces like the ones many have created under the Affordable Care Act. ...
  • [I]nstead of mandating penalties for failing to buy insurance, the approach would have automatically enrolled people unless they opted out.

Mr. Price said on Thursday that he was “cautiously optimistic” that he, other lawmakers and House Republican leaders could meld the different approaches into one alternative health plan to take to voters — and possibly the House floor — in the 2014 election season. ...