Eleven Bold Ideas
1. Heath Tax Credit: Any individual receiving healthcare insurance outside the workplace or an Obamacare exchange will receive a $2,500 per adult and $1,500 per child tax credit. This credit varies by age and geography, but not income. The credit can be spent on health insurance premiums or deposited to an HSA. It is both advanceable and refundable and can be easily administered by companies such as H & R Block, insurance brokers, employers, etc.
2. Limited Benefit Insurance: Individuals may choose a less expensive plan that includes some income and asset protection in return for a smaller tax credit. This provides a more suitable and sustainable option for families with low- income budgets.
3. Free-Market Risk Adjustment: For the first time, people with pre-existing conditions will have real protection against discrimination and the “race to the bottom” reflected in ObamaCare’s narrow networks and high drug costs for the chronically ill. Risk adjustment between health plans will ensure each plan receives an actuarially fair premium when receiving an enrollee from another plan. Plans will not benefit by seeking the healthy or avoiding the sick. Plans are free to voluntarily agree to better risk adjustments, so there will eventually be free-market risk adjustment. Based on current market conditions, we expect plans to develop that focus on specialties, such as cancer care, heart care, etc.
4. Roth Health Savings Accounts: Annual contribution limit is increased to $5,000 per individual. Roth HSAs are flexible - they can wrap around any third-party insurance plan and serve as an alternative to use-it-or-lose-it insurance. Above the tax credit amounts, any payments made to premiums or contributions to HSAs will be made with after-tax dollars. Individuals will be able to save for future health care and have an informed and active role in managing the money that pays for their care.
5. A Workable Safety Net: A portion of unclaimed tax credits – for people who remain uninsured – will be sent to safety net institutions in communities with highly uninsured populations. This restores integrity to disproportionate share money. For the first time, federal tax relief for private health insurance and federal support for safety net care will be completely integrated. Money follows people.
6. Transparency: Providers must publish the cash price of any healthcare item or service paid for by cash or an HSA. Additionally, individuals will be ensured life-saving access to healthcare without excessive charges for out-of-network emergency services.
7. Portability: Employers will be able to provide their employees with portable insurance that travels with the employee from job to job and in and out of the labor market.
8. Medicaid Funding: Medicaid will be allocated to states based on a per-capita model. This solution eliminates the incentive that current law provides states to overspend.
9. Medicaid Choice: States now have the option to allow their Medicaid enrollees to leave Medicaid, after which they can purchase private insurance and claim the tax credit.
10. Liberating the Local Practice of Medicine: National restrictions that unnecessarily prohibit the delivery of high quality health care, such as those on physician-owned hospitals, clinics and other facilities, are lifted, as are state and local restrictions on walk-in clinics, free standing surgical centers, and other market-based services.
11. Voluntary Enrollment: To minimize potential disruption, employer-sponsored plans and labor union plans can remain in the current tax system. Individuals with insurance obtained from an exchange may also elect to remain in that system. These individuals do not qualify for the health tax credit.