Issue Position: Health Care

Issue Position

Our national debate on health care has focused almost exclusively on reducing the number of uninsured Americans. However, the solution Congress crafted in the Patient Protection and Affordable Care Act, known as ObamaCare, will actually make health insurance more expensive and harder to access. It's time to find solutions that will make health care more accessible, more affordable, and help make all Americans healthier.

1) Clean Up the ObamaCare Mess
ObamaCare should be repealed for the benefit of the American health care system and the American economy. While we won't be able to repeal and replace ObamaCare until a new President takes office in 2017, Congress should pass a series of reforms now to limit the damage being caused by ObamaCare:

Delay ObamaCare Employer Mandate until 2017.

The President has already waived the job-killing Employer Mandate for a year through Executive Order, but refuses to support legislation writing this decision into law. This burdensome regulation is costing Americans jobs, as companies lay off workers in anticipation of the Mandate next year, or cut hours in order to escape its reach. Congress should delay implementation of the Employer Mandate until July 1, 2017.

Delay ObamaCare Individual Mandate until 2017.

Individuals deserve to be treated with the same consideration as businesses. America is simply not ready for the burdensome coverage mandates in ObamaCare, and the Obama Administration is incapable of effectively implementing the law. Delaying the Individual Mandate until July 1, 2017 will give Congress time to consider better ways to decrease the number of Americans without insurance, and give the American economy time to recover.

Allow consumers to keep their current insurance if they want it.

Despite President Obama;s ironclad promise, millions of Americans have received cancellation notices as insurance companies find that their policies are not allowed under ObamaCare. Congress should allow consumers to keep and update their current coverage, for as long as they want to stay with their current insurance carriers. You should be able to keep your plan and your doctor.

Repeal the Medical Device Tax

One of the most short-sighted provisions of ObamaCare was a 2.3% excise tax on medical devices, estimated to raise $29 billion over the next ten years. It's ridiculous to think that making everything from tongue depressors to pacemakers more expensive will do anything but drive up health care costs. Congress should repeal this job-killing tax on medical innovation, which will save money for hospitals and patients.

Restore $716 Billion in Medicare cuts used to prop up ObamaCare

Another way that Congress attempted to pay for ObamaCare was by short-changing Medicare by $716 billion, cutting reimbursements to hospitals, the Disproportionate Share Hospital Program, and Medicare Advantage. These backdoor cuts to Medicare reimbursement rates are a hidden tax on hospitals and patients, and we end up paying for them through higher insurance premiums.

2) Make Insurance More Affordable
We need to find better ways to bring down the cost of health insurance for all Americans. Simplifying the tax code and removing barriers to competition will go a long way to bending the cost curve for health insurance.

Full deductibility for individual health insurance

The tax code allows employers to deduct the cost of health insurance benefits, but does not allow similar deductions for individuals who buy their health insurance on the open market. This is why so much of the health insurance marketplace is dominated by employer-sponsored plans, and why there is so little competition in the individual market. Allowing full deductibility for health insurance premiums would boost the individual market, and increase choice and competition among health insurance providers, leading to lower healthcare costs.

Tax-free Medical Retirement Accounts

Anyone retiring at age 65 can expect to pay more than $100,000 in future medical expenses, and that bill will continue to rise as we live longer. End of life care is one of the largest drivers of increased health care expenditures. Medical Retirement Accounts will allow workers to save towards their own health care, reducing pressure on Medicare and Social Security, and preventing us from leaving our children with crippling medical bills. MRAs would be allowed to grow tax-free, and any surplus not spent on health care could be cashed out or passed on to survivors at prevailing income tax rates.

Expand Health Savings Accounts

Since 2003, Health Savings Accounts have allowed people to save money by purchasing high deductible insurance plans, and use pre-tax earnings in an HSA to cover both routine and unexpected medical costs. But ObamaCare has disallowed many of these high deductible plans. Congress should remove restrictions on HSAs.

Interstate Insurance Flexibility

State laws limits consumers to insurance policies licensed in their state, often with costly restrictions and coverage mandates. Congress should encourage interstate commerce by allowing Americans to buy health insurance across state lines. Alternatively, insurance companies should be allowed to seek an Optional Federal Charter, which would allow them to sell federally licensed insurance products nationwide.

Cap malpractice payments and sanction frivolous lawsuits

Skyrocketing medical malpractice insurance rates not only drive up health care costs, but they drive doctors out of business, often leaving rural residents without access to vital services. Capping non-economic damages would ensure that patients who suffer from medical errors would still be able to sue for compensation, while limiting doctors from being exposed to unlimited liabilities. Shifting to a "Loser Pays" model for lawsuits deemed frivolous would force lawyers to pay for bringing groundless lawsuits. President Obama has repeatedly called for reforms to our tort and class-action systems, but has refused to back any specific legislation. We need to come together to prevent junk lawsuits from driving up health care costs for all of us.

3) Improve Access
Getting costs under control is only one step towards health care reform. We also need to adopt common sense solutions to improve access to world-class medical care, regardless of where we live and how much we make.

Give states greater flexibility over Medicaid

Medicaid's 50-50 cost sharing arrangement between states and the federal government provides incentive for states to increase the amount of matching dollars they receive rather than look for ways reduce costs. In 2009, Rhode Island received unique flexibility to reform its delivery of Medicaid services in exchange for a cap on federal spending. Over the last four years, these reforms have cut the rate of Medicaid growth to half the national average while reducing unnecessary emergency room visits and improving access to health care for Medicaid patients. Congress should give every state the same flexibility that has already saved taxpayers $2.3 billion in Rhode Island alone.

Streamline FDA approval to bring life-saving prescription drugs to market faster

The Food and Drug Administration requires three stages of testing before a new drug can be offered, an arduous process that can take up to 12 years and $1.3 billion to bring a single new drug to market. Even after a new drug has been deemed safe by the FDA doctors must sometimes wait an additional three years before they can prescribe the drug to their chronically and terminally ill patients. In 2012, Congress came together to pass bipartisan FDA reform to make sure pharmaceutical companies rather than taxpayers were paying for drug testing. We can come together again to remove a layer of red tape that prevents tomorrow's miracle drugs from helping chronically and terminally ill patients today.

4) Improve Health Care Outcomes
Health insurance isn't the health care problem we face, and Congress doesn't have all the answers. We can encourage better doctors and hospitals to do the following:

Adopt Mayo Clinic approach to medical errors

The Institute of Medicine estimates that medical mistakes kill 100,000 a year. The Mayo Clinic has begun to track and study medical errors, in order to find ways to prevent them in the future.

Crowdsource diagnostic second opinions through Best Doctors

Diagnostic expenses are a key driver of higher health insurance costs, in part because doctors order unnecessary tests in order to avoid future liability. But diagnostic error also wastes an estimated $312 billion annually, and results in patients receiving improper treatment. Harvard physicians started the Best Doctors Program to improve second opinions. A recent trial of 60 patients found improved diagnoses and treatments in 85% of patients, leading to $500,000 in savings.

Risk Assessment Exams

Overtreatment increases costs and subjects patients to unnecessary tests and procedures. Yet preventative medicine for people at risk of chronic diseases like diabetes, heart disease, and cancer can catch deadly diseases when they are treatable. Hospitals should work to improve best practices for risk assessment to better determine which patients would benefit most from preventative care.

Institute Prize-Based Funding for medical research

Our current federal research programs are guided more by political connections than by scientific promise. Shifting to a prize-based funding would revolutionize the incentives for medical research, and ensure that taxpayers are paying for real results. This bipartisan solution will help keep America on the cutting edge of medical technology.

Source