What a few weeks it’s been. Washington is more divided than ever before. I am not sure why President Trump thinks that his latest attempts to coerce the Republican Congress will work better than his past efforts.

The Democrats relied on 60 votes to get the Affordable Care Act through ,and now the Republicans are trying to rely on 50 votes to make their mark. The Congressional Budget Office scoring on repeal and replace was a disaster. And it doesn’t take a lot of reflection to realize that there is no turning back on some of the ACA changes. For example, guaranteed issue and Medicaid expansion, which the states are going to have a hard time backpedaling on politically.

Bloomberg/file photo

With reality setting in, perhaps we can now collectively agree that we need bipartisan commitment to fix healthcare.

Here are some thoughts:

  1. Increase the individual penalty so that the free riders get hurt if they aren’t in the system. Medicare does this very effectively and can be a model.
  2. Increase rating bands from three to five. Twenty-seven-year-olds simply can’t afford to subsidize older Americans to the extent that we have asked them to do so.
  3. Create a federal system to backstop high cost claimants. The luck of the draw should be spread evenly, not just to the risk pools where they fall.
  4. Rein in pharmacy inflation and mandate transparency.
  5. Do something about tort reform.

There’s a start. Hopefully it will get some traction.

Register or login for access to this item and much more

All Employee Benefit Adviser content is archived after seven days.

Community members receive:
  • All recent and archived articles
  • Conference offers and updates
  • A full menu of enewsletter options
  • Web seminars, white papers, ebooks

Don't have an account? Register for Free Unlimited Access