The uncertainty and lack of clarity over what’s coming with the Affordable Care Act’s replacement plan is an opportunity for advisers to lead and help make real change. The chance to influence the conversation has never been better. Along with 1,000 National Association of Health Underwriters members from across the country, we recently hit Capitol Hill to meet with our legislators to talk healthcare reform and to influence the process. What did we learn?
Despite the Republican majority in both chambers of Congress, there is no clearly favored plan or a set of principles to govern the process. Most of the conversations centered on “fixing” insurance laws which are conveniently being blamed for high health insurance premiums (I will share why this is misguided below). Things like repealing the individual and employer mandates, removing the requirement to buy a government-approved health plan and eliminating the subsidies to buy health insurance and pay for out-of-pocket costs for eligible enrollees were the topics of conversation.
Replacement ideas sound mostly like recycled ideas from the past: tax credits instead of subsidies, block granting Medicaid dollars to the states and purchasing across state lines, as well as some troubling “new” thinking about taxing employer-sponsored insurance. We even heard keeping two popular provisions of the ACA: allowing kids to remain on their parent’s plan until age 26 and making health insurance accessible to people with pre-existing conditions.
The sad truth
Disappointingly, these policy provisions aren’t new, innovative or designed to solve the real problem of rapidly rising costs.
I think it’s safe to say President Donald Trump’s “thing” isn’t healthcare reform. He doesn’t get into the details and uses populist rhetoric to describe his vision for a better design where no one gets left behind. To his credit, the president wants to expand and improve health savings accounts because he knows doing so will create more consumerism in healthcare. He understands that while the ACA did provide insurance to more Americans, it is seriously flawed and hurting individuals and businesses all across our land.
Also see: “30 benefit thought-leaders to know.”
Most importantly, the president is aware of the heavy regulatory burden and high cost of the ACA. He believes we can do better and so do I.
Fortunately, the president appears to understand the real problem: Health insurance is expensive because healthcare is expensive. This understanding is evident through one of his core principles for healthcare reform: transparency of healthcare cost and quality. Yet, when NAHU members raised the subject on our Capitol Hill visits we were told, “You know, that’s not a very popular position up here on the Hill.”
And our response was, “Yes. We understand, and that is why we are looking for your leadership.”
The sad truth is that exchange is the reality of the challenge we face — protecting the status quo. The rule-makers don’t want transparency because it would be a game-changer, and one they don’t welcome.
Transparency of healthcare cost and quality would expose the game and show all of us just how badly we are all being fleeced. Instead, we play the game and, in so doing, live somewhere between order and chaos. With the ACA replacement plan still very much in play, let’s all join forces to make healthcare cost and quality transparent and stop this nonsense. The time is now.
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