Tag: ACA

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Price Transparency In Medicine Faces Stiff Opposition — From Hospitals And Doctors

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“The hospitals complain that they cannot publish their prices because they would have to ask the insurer in order to state the price up front. What other industry thinks like that? “How much is this dress?” Answer, “What credit card are you using?” Forget the insurer. What is the best CASH, check or credit card price? ” Alieta Eck, MD For Real Health Care Reform

By Rachel Bluth July 25, 2017

COLUMBUS, Ohio — Two years after it passed unanimously in Ohio’s state Legislature, a law meant to inform patients what health care procedures will cost is in a state of suspended animation.

One of the most stringent in a group of similar state laws being proposed across the country, Ohio’s Healthcare Price Transparency Law stipulated that providers had to give patients a “good faith” estimate of what non-emergency services would cost individuals after insurance before they commenced treatment.

But the law didn’t go into force on Jan. 1 as scheduled. And its troubled odyssey illustrates the political and business forces opposing a common-sense but controversial solution to rein in high health care costs for patients: Let patients see prices.

Many patient advocates say such transparency would be helpful for patients, allowing them to shop around for some services to hold down out-of-pocket costs, as well as adjust their household budgets for upcoming health-related outlays at a time of high-deductible plans.

https://khn.org/news/price-transparency-in-medicine-faces-stiff-opposition-from-hospitals-and-doctors/

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The Pitfalls of Single-Payer Health Care: Canada’s Cautionary Tale

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by CANDICE MALCOLM

April 13, 2017
4:00 AM
Before resigning themselves to socialized medicine, flummoxed legislators should consider the experience of our neighbors to the North. In the Netflix series House of Cards, President Frank Underwood campaigned for the White House by telling Americans, “You are entitled to nothing.” The fictional president — a Democrat, no less — was forthright with American voters about the unaffordable and unsustainable structure of America’s entitlement programs, and he was rewarded at the polls. In real-life America, unfortunately, there is no such courageous honesty from the political class. Even many in the Republican party, once the stalwart force fighting against the growth of big government, are now resigned to contemplating a government takeover of the health-care industry in the wake of their failure to repeal and replace Obamacare. Charles Krauthammer, for example, woefully predicts that President Trump will opt for single-payer health care. F. H. Buckley, meanwhile, optimistically calls for Trump to look to the Canadian model of universal coverage. There’s just one problem: The Canadian model of universal coverage is failing.

Read more at: https://www.nationalreview.com/article/446689/canadas-single-payer-health-care-system-cautionary-tale

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Picking apart Cory Booker’s latest health care nonsense, point by point

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file photo by Boyd Loving

By Herman Cain —— Bio and Archives March 20, 2017

As Republicans in Congress continue to craft a legislative solution to the disastrous Unaffordable Care Act, the Democrats continue to mislead its defenders with more and more dishonest and deceptive rhetoric. The latest installment comes from Senator Cory Booker (D-New Jersey), and is deserving of a complete deception diagnosis.

By the way, Booker is considered by Democrats to be a future Democrat presidential candidate, and he won the un-coveted “Liberal Lunacy of the Week” last week on the Herman Cain Radio Show with the following litany of false statements:

“The Republicans cannot just force this down our throats.  It’s going to knock a lot of folks off, hurt long-term care, hurt good working class folks.  I don’t understand this almost, I don’t understand their political strategy because this is bad politics.  Deeper than that it is bad policy and bad process.”

Let’s break this down, shall we?

The Republicans cannot just force this down our throats.

Most of us will recall then House Speaker Nancy Pelosi, saying that the Democrats had to pass the UCA and then tell us what was in it. They did just that in 2010 with no Republican votes in Congress, because it was that bad and they wanted no Republican input. They forced it down our throats.

In 2017, the Republicans’ American Health Care Act (AHCA) is working its way through Congress and we know what’s in it, and sensible people like most of it. Some of the favorite features are no mandates, no penalties, repeal of taxes hidden in the UCA, and allowing the states to manage Medicaid. These features are the exact opposite of what’s in the UCA, which has failed miserably.

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“20 million people gained healthcare due to Obamacare” , Not So Fast

Obama-Golf
March 16,2017

the staff of the Ridgewood blog

Ridgewood Nj, you have heard it over and over again ,”20 million people gained healthcare due to Obamacare. This confirms that Obamacare was successfully addressing the underlying problems within the healthcare market.”

The reality is far different ,the majority of these people were simply placed on an expanded version of Medicaid, meaning, rather than addressing the issues plaguing the dysfunctional healthcare market, Obamacare did little to improve markets and simply pushed people into government-run healthcare, paid by taxpayers.

People keep touting, as though it were some sort of success story, that “more people have health insurance today due to Obamacare.” This particular talking point seems astonishingly absurd, however, since Obamacare contained within it a MANDATE that FORCED people to get health insurance. Of course, if you put a gun to someone’s head and tell them to buy something, they’re more likely to buy it. This is akin to passing a law requiring everybody to buy one additional pair of shoes, then proclaiming yourself a business genius because you then saw shoe sales increase. If sales didn’t increase because the product became more affordable or more desirable, however, it should be obvious that you didn’t actually “fix” anything.

Let’s take a look at the numbers:

• A 2015 estimate showed that, of the 20 million newly insured people, 14.5 million were put on Medicaid and CHIP (Children’s Health Insurance Program). [a]

• Of this 14.5 million placed on tax-payer financed health insurance, about 3.4 million were previously eligible before Obamacare [b], but hadn’t enrolled because they didn’t need it. That means tax payers are paying the health insurance costs of 3.4 million people who knew they didn’t actually need it but were forced to accept the hand-out anyways since Obamacare mandates they have insurance.

• Additionally, of the 20 million, 2.3 million were simply young adults (aged 19 to 25) who gained coverage between 2010 and 2013 as a result of Obamacare’s provision which said they got to stay on their parent’s insurance until they were 26. [c] People 19-25 rarely require extensive healthcare, however, which is why they rarely choose to buy it themselves. So while letting them stay on their parent’s insurance may have been helpful in a handful of circumstances, it was mostly “fixing” a problem which did not exist. Matter of fact, the reason the ACA wanted younger people insured was precisely BECAUSE they don’t get sick enough to cost money, and thus represent income for health insurance providers rather than costs.

• Lastly, in 2016, the numbers didn’t look much better. Preliminary data indicated that net total enrollment increased by “2,535,020 individuals in the first three-quarters of 2016.” [d] But of that 2.5 million increase, the net increase in PRIVATE (market) insurance was actually only “490,211 individuals.” Again, Medicaid accounted for “81 percent of the incremental growth in enrollment in 2016.” [d]

Thus, roughly 81% of the newly insured people in 2016 were simply given free insurance which everyone else funded. How is that a success? A successful reform would have seen people affording their own private health insurance – when and only IF they wanted it – because the product would have gotten better, cheaper, or both. Instead, since that wasn’t accomplished, Obamacare simply pushed people into government-run insurance to pretend it had “solved” the problem. It was called “The AFFORDABLE Care Act,” but a more appropriate name would have been “The Forced Welfare Expansion Act.”
———————-
Sources:
[a]
https://aspe.hhs.gov/…/de…/files/pdf/187551/ACA2010-2016.pdf

[b]
https://kff.org/…/state-indi…/medicaid-expansion-enrollment/…

[c]
https://aspe.hhs.gov/syst…/files/pdf/187551/ACA2010-2016.pdf

[d]
https://budget.house.gov/…/house_budget_testimony-haislmaier…

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Health Coverage does Not Equal Health Care

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Ridgewood Nj,one again many have demonstrated selective anesthesia, so here is a reminder of Obamacare architect Jonathan Gruber bragging about deceiving the American people, who he thinks are stupid.

Obamacare Architect Jonathan Gruber not only twice admits fooling stupid Americans but admits the concerted effort in the to mislead what the ACA or Obamacare is all about and what it goals are .

In a report, released by the Alliance for a Just Society,in 2015 is the result of a yearlong study that included a survey of 1,200 low-income people in 10 states and was conducted in Spanish, Cantonese and English. It found that people of color, families in rural communities and those with language and cultural barriers still struggle to get health care and pay for it.

The conclusion was , “cost was a struggle even in states that expanded Medicaid, where insurance premiums paid by people every month can be high.” “While the racial barriers are significant, the biggest barrier for enrollment for people of color was premium cost,”

The Heritage foundation came up with the exact same conclusion in 2013 . Many of Obamacare’s beneficiaries have already discovered or will eventually discover that there’s a big difference between insurance coverage and access to health care services.

Today, the New York Times highlighted a report by the Department of Health and Human Services that shows access to care in the Medicaid program is very limited.

The study, conducted between July 2013 and October 2013, concludes that more than half of providers could not offer appointments to Medicaid managed care enrollees with 35 percent of providers listed under an erroneous location. Nor were those the only issues, according to the report:

Among the providers who offered appointments, the median wait time was 2 weeks. However, over a quarter had wait times of more than 1 month, and 10 percent had wait times longer than 2 months. Finally, primary care providers were less likely to offer an appointment than specialists; however, specialists tended to have longer wait times.

This is neither surprising nor a new conclusion. The Medicaid program has a long and well-documented history of limited access to care and poorer health outcomes for beneficiaries compared to those with private insurance.

 

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MEDICAID 2.0 PROVIDES BLUEPRINT FOR HEALTHCARE REFORM IN GARDEN STATE

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LILO H. STAINTON | MARCH 7, 2017

New Jersey’s Medicaid program serves almost 2 million clients; increased cost efficiencies and enhanced responsiveness are a must — especially with ACA under fire

New Jersey’s Medicaid program, the health insurance plan that covers nearly one in every five residents, is in desperate need of modernization to better serve patients and provide them higher-quality care while remaining financially sustainable in the years to come.

That’s the assessment of a diverse group of healthcare stakeholders convened more than a year ago by the New Jersey Health Care Quality Institute to review the massive program, explore successful efforts in other states, and recommend reforms to improve the delivery of Medicaid in the Garden State. Representatives of the group, whose work was funded by the Nicholson Foundation, unveiled on Monday the results of their work: the Medicaid 2.0 Blueprint, a detailed plan with 24 specific recommendations designed to make the system more efficient, better integrated, and more responsive to patient needs.

https://www.njspotlight.com/stories/17/03/06/medicaid-2-0-provides-blueprint-for-healthcare-reform-in-garden-state/?utm_campaign=new-jersey-politics&utm_content=2017-08-03-9074583&utm_source=Sailthru&utm_medium=email&utm_term=New%20Jersey%20Politics

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4 Broken Obamacare Promises That Town Hall Protesters Should Remember

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Jean Morrow / @Jean_Morrow2013 / February 15, 2017

While the House and Senate plan to repeal and replace Obamacare, members of Congress are hosting town hall meetings with their constituents and have been greeted by hostile crowds.

These folks seem to have amnesia about Obamacare’s glaring failures.

Here’s a quick refresher on Obamacare’s top four broken promises.

1. Costs are exploding.

President Barack Obama promised that his reform proposal would cut typical family costs by $2,500 annually. That, of course, never materialized.

The typical family today pays about 35 percent of their income for health care.

The small group and individual insurance markets were hit hard by big premium increases. An eHealth report concluded that from 2013 to 2017, the average individual market premium increases were 99 percent for individuals and a jaw-dropping 140 percent for families.

Costs have also increased for those with employer-sponsored insurance, according to the Kaiser Family Foundation, from 2010 to 2016, average family premiums for employer-sponsored plans nearly increased 32 percent.

Higher premiums are not the only shock. Out-of-pocket costs in the Obamacare exchanges, particularly deductibles, have been stunning. HealthPocket analyzed that for the lowest tier bronze plans in 2017, the average deductible for an individual is $6,092 and $12,383 for a family.

2. Competition and choice are declining.

Obama told America his proposal would increase competition in the health insurance markets but that hasn’t happened either.

On Tuesday, news broke that Humana will be leaving the Obamacare exchange markets next year. This was just the latest in a growing list of insurers who are jumping ship from this massive public policy failure.

Town hall audiences should take a good look at county-level data. A new Heritage Foundation analysis found that Obamacare’s exchanges, in their fourth year of operation, offer Americans little health insurer choice.

The downward slide in competition means that in 2017, consumers in 70 percent of U.S. counties are left with just one or two insurer options on the exchanges. The 70 percent figure is way up from 36 percent in 2016.

3. Forget about keeping your plan.

Perhaps the most famous health care promise of all, Obama’s promise: “If you like your health care plan, you’ll be able to keep your health care plan.” In fact, there were 37 instances where Obama or a high-ranking administration official repeated that infamous promise to keep you plan and your doctor.

Rarely has there been such a disconnect between rhetoric and reality. In 2014, the first year that Obamacare was fully implemented, the Associated Press reported that there were at least 4.7 million canceled policies across 30 states. The law’s insurance rules and mandates forced many insurers to cancel plans that people liked and wanted.

Sadly, the disruption only continued from there. For example, hundreds of thousands of people signed up for plans offered by insurers under Obamacare’s co-op program.

But 18 out of 23 of these federally-funded insurers have already collapsed, meaning taxpayers are highly unlikely to be repaid the more than $1.9 billion in loans they received—not to mention the thousands of co-op enrollees that lost their health care plans, some in the middle of the year.

Not exactly a proud moment in public policy.

4. No, you can’t necessarily keep your doctor.

Obama promised patients that they would be able to keep their doctors. For many patients, that also turned out to be untrue.

Obamacare’s rising costs, and its limited flexibility in federally fixed benefit designs, resulted in plans resorting to narrow provider networks. Narrow networks limit access to doctors and other medical professionals as a way to contain costs.

Enough is enough. For seven years, Obamacare has proved to be one giant bundle of broken promises and policy failures. Congress needs to get serious—quickly—and repeal Obamacare.

This is a crucial first step in moving America toward the patient-centered health care system our country deserves.

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“It’s not going to get any better; it’s getting worse,” CEO of Aetna, Mark Bertolini said in an interview at a Wall Street Journal event

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Aetna CEO: Obamacare markets are in a ‘death spiral’

By PAUL DEMKO

Updated 02/15/17 10:28 AM EST

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Obamacare is in a “death spiral,” the influential CEO of Aetna, Mark Bertolini, declared Wednesday morning.

Bertolini’s doomsday prophesy: More insurers will pull out of the government-run marketplaces in the coming weeks and many areas will have no insurers to provide Affordable Care Act coverage in 2018.

“It’s not going to get any better; it’s getting worse,” Bertolini said in an interview at a Wall Street Journal event. But he declined to say whether Aetna would completely pull out of Obamacare markets next year.

Humana, which had already significantly limited its exchange footprint this year, announced Tuesday that it would completely pull out of the exchange markets next year after determining its customer base would still be unprofitable. That followed major pullbacks this year from other national insurers, including Aetna and UnitedHealth Group.

 

https://www.politico.com/story/2017/02/obamacare-market-death-spiral-aetna-mark-bertolini-235041

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New Jersey bucks national trend in Obamacare enrollment

obamacare_theridgewoodblog

 

 By Kathleen O’Brien | NJ Advance Media for NJ.com
on February 09, 2017 at 10:48 AM
New Jersey bucked a national trend of declining enrollment in Obamacare health insurance, but just barely, according to the tally released by the Trump administration.

January provided a roller-coaster timetable for consumers: They could sign up for subsidized health insurance through the 31st, if they were eligible.

Yet a new president took office Jan. 20, and one of his first actions was to sign an executive order aimed at withdrawing support of the Affordable Care Act.

Television and radio commercials that had always aired during the last week of enrollment to warn procrastinators of the upcoming deadline were cancelled – then reinstated after protest.

There is usually a surge of about 700,000 people signing up on the federal Obamacare website, healthcare.gov, at the last minute. This year, however, that number was cut nearly in half, to 375,000.That meant an overall drop in the number of Americans who now purchase their policies through the federal marketplace.

Nationally, roughly 12.2 million signed up for Obamacare in 2017, versus 12.7 million in 2016 through the federal marketplace and state-run exchanges.

In New Jersey, though, the situation was markedly different.

The pace of new enrollments dropped once Trump took office, but by the close of the open enrollment window, 295,067 New Jersey residents had acquired insurance through the federal marketplace.

That’s a about a two percent increase over last year’s enrollment of 288,573.

https://www.nj.com/healthfit/index.ssf/2017/02/obamacare_sign-ups_tank_-_but_not_in_new_jersey.html

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NJ hospitals: Obamacare repeal would slam us

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Massachusetts Institute of Technology Professor Jonathan Gruber Obamacare architect said last year that a “lack of transparency” and the “stupidity of the American voter” helped Congress approve ObamaCare

Michael L. Diamond , @mdiamondappPublished 5:02 p.m. ET Jan. 26, 2017

New Jersey hospitals would be hit hard by the repeal of Obamacare if Congress doesn’t replace it with a law that would include similar levels of insurance coverage, their trade group said Thursday.

Hospitals  would lose money from both private insurance and Medicaid reimbursements. They would need to treat more consumers who lose their coverage in emergency departments. And both would put a strain on their bottom line, officials said.

https://www.app.com/story/news/local/new-jersey/2017/01/26/nj-hospitals-obamacare-repeal/97078816/

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Reminder :Obamacare Architect Jonathan Gruber Twice Admits Fooling Stupid Americans

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Reader comments , “The individual mandate ensured that the pool would not only be sick people.

The mandate also protects taxpayers. People without health insurance will get sick and wind up in hospitals. The uninsured will be a burden to hospitals that do charity work (not Valley). They are healthy right now. Eventually some will find out that they have an illness or they may have an accident. Then they will need charity care and can run the risk of going bankrupt. I do not want to underwrite their medical bills- the way we used to. I don’t care if they go bankrupt.”

Obamacare Architect Jonathan Gruber Twice Admits Fooling Stupid Americans

Ridgewood NJ, In the clip , Massachusetts Institute of Technology Professor Jonathan Gruber appears on a panel and discusses how the reform earned enough votes to pass.

He suggested that many lawmakers and voters didn’t know what was in the law or how its financing worked, and that this helped it win approval.

“Lack of transparency is a huge political advantage,” Gruber said. “And basically, call it the stupidity of the American voter or whatever, but basically that was really, really critical for the thing to pass.”

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Trump may not enforce individual health insurance mandate: aide

obamacare_theridgewoodblog

ReutersJanuary 22, 2017

WASHINGTON (Reuters) – The Trump administration may no longer enforce a rule requiring individual Americans to carry health insurance or pay a penalty if they do not, a senior White House official said on Sunday

Speaking on ABC’s “This Week” program, Kellyanne Conway, counselor to the president, said President Donald Trump “may stop enforcing the individual mandate.”

Separately, on CBS’ “Face the Nation” show, she reiterated Republican promises that no one would lose their health insurance under Obamacare while a replacement is being developed.

“For the 20 million who rely upon the Affordable Care Act in some form, they will not be without coverage during this transition time,” she said.

On Friday Trump signed an executive order concerning the 2010 healthcare law, urging U.S. agencies to “waive, defer, grant exemptions from, or delay the implementation” of provisions deemed to impose fiscal burdens on states, companies or individuals.

Healthcare experts had speculated that Trump could expand exemptions from the individual mandate.

https://ca.news.yahoo.com/americans-wont-lose-coverage-health-law-reform-trump-150013365.html

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What If Sick People Lose Their ObamaCare?

obamacare_theridgewood blog

By Jane M. Orient, M.D.

As Republicans contemplate repealing the Affordable Care Act (ACA or “ObamaCare”)—seriously, not just as a political gesture—alarms are sounding about millions of individuals losing coverage.

So soon we have forgotten about the millions who lost coverage they had had for years because ObamaCare outlawed it.

ObamaCare resulted in perhaps five times as many losers as winners—even counting just those who ended up with more expensive or less desirable coverage. If you count the taxpayers, the tally of losers is much higher. But with government largesse, the losers—the ones who have their earnings taken away—are “forgotten men.”

Anyone who has government-funded benefits taken away, on the other hand, becomes a victim.

The best poster children are cancer victims. They face a premature, particularly nasty death. Who would deny someone’s mother or 4-year-old daughter the chance of a cure, even if the chemotherapy costs more than $100,000?

ObamaCare would. Exchange plans have excluded the best cancer hospitals from their narrow networks. Medicaid would. It might call the treatment “experimental” or “not cost-effective.” Medicare would, possibly just because the patient is “too old” or “too young.” Unless the particular victim can be featured in a PR campaign to “save ObamaCare,” she might be “better off with the pain pill,” as President Obama put it.

And let’s not forget how the FDA has driven the costs of drug approval sky-high, suppresses therapies that have no prospect of turning billion-dollar profits, and protects manufacturers against competition when the drug is about to go off patent. The anti-leukemia drug Gleevec, for example, cost $26,000 per year in 2001, a price called “high but fair,” considering the cost of research and the need for profits. It is $146,000 a year today, but the introduction of cheaper generics in the U.S. is being delayed.

https://aapsonline.org/sick-people-lose-obamacare/

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Obamacare repeal and replacement: The case for moving quickly

obamacare_theridgewoodblog

By Robert E. Moffit, Ph.D.

ABOUT THE AUTHOR

Robert E. Moffit, Ph.D.Senior Fellow
Center for Health Policy Studies

President-elect Donald Trump has repeatedly promised voters he will repeal and replace the Affordable Care Act. Now he and his congressional allies have an obligation to fulfill that promise.

Despite some hysterical claims to the contrary, Congress isn’t going throw millions of Americans out of coverage. Under Obamacare, most newly insured people have been enrolled in Medicaid, a welfare program, while the bulk of those covered in the troubled exchanges are getting generous taxpayer subsidies. Thus far, at least, congressional leaders appear focused on avoiding further disruption and securing a smooth transition, particularly for those enrolled in the exchanges and Medicaid.

Meanwhile, there is another, more pressing, problem. There are more than 10 million people in the individual market who get no ACA taxpayer subsidies for their insurance yet are being hit with staggering premium increases.

Moreover, there are also approximately 15 million Americans in the small group markets – small-business employers and employees – who are likewise facing escalating premiums.

In the Obamacare exchanges, the average increase in the benchmark plan premium will be 25 percent for 2017 in the 39 states using the HealthCare.gov platform, and the exchange deductibles are positively breathtaking. For plans with the lowest premium costs, the so-called bronze plans, the average deductible for single coverage is $6,000 annually, while family coverage climbs to more than $12,000.

Premium subsidies aren’t available for many in the middle class. A single person making more than $47,000 is out of luck for help in offsetting her premium costs. And if she makes roughly $15 an hour, she will likely be ineligible for cost-sharing subsidies.

Trump and Congress are inheriting unstable insurance markets. In droves, millions of Americans expected to sign up in the exchanges have not; middle class folks, especially young folks, clearly don’t see much value in high-priced insurance with crazy deductibles.

So a larger proportion of older and sicker people, whose claims costs are often higher than their premium contributions, are driving costs higher. And the individual mandate penalty, which is riddled with exemptions, isn’t much of an incentive to buy Obamacare coverage.

There has also been the steep reduction in health plan competition since the inception of the exchanges in 2014. By underpricing the product, perhaps in hopes of federal bailouts, and then failing to recover sufficient revenues, many of the plans have been losing money, and major plans have withdrawn from the exchanges altogether.

The Obama administration’s political remedies to enhance competition in the exchanges have either failed or become another excuse for more taxpayer bailouts. Note the stunning collapse of the co-op program – 18 out of 23 have disappeared from the markets – and the equally important but overlooked dismal performance of the federally sponsored multistate plans administered by the U.S. Office of Personnel Management. They enroll just 440,000 people, or 4 percent of the entire exchange population.

The new president and Congress must act decisively to stabilize the insurance markets that exist as well as lay the groundwork for the improved markets they envision. Through a combination of early administrative and legislative actions, they can reduce costs and stabilize the insurance markets. Among the many other provisions to be enacted or implemented, they must do at least the following:

– Reduce the costs in the individual and small group markets by liberalizing insurance rules, particularly the federal benefit and insurance rating rules, which artificially drive up premium costs for young families.

– Reduce the costs of employer-sponsored insurance. Administratively, this can be done by liberalizing the “grandfather rules,” thus allowing employers greater flexibility to alter or modify their plans, delaying the employer mandate reporting and penalty requirements. Legislatively, Congress should kill the employer mandate entirely.

– Provide individual tax relief for Americans buying health insurance if they do not or cannot get health care coverage through the place of work.

Trump and Congress must move quickly to prevent even greater disruption to the badly damaged health insurance markets. While Obamacare was designed to insure the uninsured, now Obamacare costs threaten to un-insure those who are insured. It’s time to act.

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Health Care Begins With Full Repeal of Obamacare Tax

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HEALTHCARE REFORM TO MAKE AMERICA GREAT AGAIN

Janaury 19,2017

the staff of the Ridgewood blog

Ridgewood NJ, Since March of 2010, the American people have had to suffer under the incredible economic burden of the Affordable Care Act—Obamacare. This legislation, passed by totally partisan votes in the House and Senate and signed into law by the most divisive and partisan President in American history, has tragically but predictably resulted in runaway costs, websites that don’t work, greater rationing of care, higher premiums, less competition and fewer choices. Obamacare has raised the economic uncertainty of every single person residing in this country. As it appears Obamacare is certain to collapse of its own weight, the damage done by the Democrats and President Obama, and abetted by the Supreme Court, will be difficult to repair unless the next President and a Republican congress lead the effort to bring much-needed free market reforms to the healthcare industry.

But none of these positive reforms can be accomplished without Obamacare repeal. On day one of the Trump Administration, we will ask Congress to immediately deliver a full repeal of Obamacare.

However, it is not enough to simply repeal this terrible legislation. We will work with Congress to make sure we have a series of reforms ready for implementation that follow free market principles and that will restore economic freedom and certainty to everyone in this country. By following free market principles and working together to create sound public policy that will broaden healthcare access, make healthcare more affordable and improve the quality of the care available to all Americans.

Any reform effort must begin with Congress. Since Obamacare became law, conservative Republicans have been offering reforms that can be delivered individually or as part of more comprehensive reform efforts. In the remaining sections of this policy paper, several reforms will be offered that should be considered by Congress so that on the first day of the Trump Administration, we can start the process of restoring faith in government and economic liberty to the people.

Congress must act. Our elected representatives in the House and Senate must:

Completely repeal Obamacare. Our elected representatives must eliminate the individual mandate. No person should be required to buy insurance unless he or she wants to.
Modify existing law that inhibits the sale of health insurance across state lines. As long as the plan purchased complies with state requirements, any vendor ought to be able to offer insurance in any state. By allowing full competition in this market, insurance costs will go down and consumer satisfaction will go up.
Allow individuals to fully deduct health insurance premium payments from their tax returns under the current tax system. Businesses are allowed to take these deductions so why wouldn’t Congress allow individuals the same exemptions? As we allow the free market to provide insurance coverage opportunities to companies and individuals, we must also make sure that no one slips through the cracks simply because they cannot afford insurance. We must review basic options for Medicaid and work with states to ensure that those who want healthcare coverage can have it.
Allow individuals to use Health Savings Accounts (HSAs). Contributions into HSAs should be tax-free and should be allowed to accumulate. These accounts would become part of the estate of the individual and could be passed on to heirs without fear of any death penalty. These plans should be particularly attractive to young people who are healthy and can afford high-deductible insurance plans. These funds can be used by any member of a family without penalty. The flexibility and security provided by HSAs will be of great benefit to all who participate.
Require price transparency from all healthcare providers, especially doctors and healthcare organizations like clinics and hospitals. Individuals should be able to shop to find the best prices for procedures, exams or any other medical-related procedure.
Block-grant Medicaid to the states. Nearly every state already offers benefits beyond what is required in the current Medicaid structure. The state governments know their people best and can manage the administration of Medicaid far better without federal overhead. States will have the incentives to seek out and eliminate fraud, waste and abuse to preserve our precious resources.
Remove barriers to entry into free markets for drug providers that offer safe, reliable and cheaper products. Congress will need the courage to step away from the special interests and do what is right for America. Though the pharmaceutical industry is in the private sector, drug companies provide a public service. Allowing consumers access to imported, safe and dependable drugs from overseas will bring more options to consumers.

The reforms outlined above will lower healthcare costs for all Americans. They are simply a place to start. There are other reforms that might be considered if they serve to lower costs, remove uncertainty and provide financial security for all Americans. And we must also take actions in other policy areas to lower healthcare costs and burdens. Enforcing immigration laws, eliminating fraud and waste and energizing our economy will relieve the economic pressures felt by every American. It is the moral responsibility of a nation’s government to do what is best for the people and what is in the interest of securing the future of the nation.

Providing healthcare to illegal immigrants costs us some $11 billion annually. If we were to simply enforce the current immigration laws and restrict the unbridled granting of visas to this country, we could relieve healthcare cost pressures on state and local governments.

To reduce the number of individuals needing access to programs like Medicaid and Children’s Health Insurance Program we will need to install programs that grow the economy and bring capital and jobs back to America. The best social program has always been a job – and taking care of our economy will go a long way towards reducing our dependence on public health programs.

Finally, we need to reform our mental health programs and institutions in this country. Families, without the ability to get the information needed to help those who are ailing, are too often not given the tools to help their loved ones. There are promising reforms being developed in Congress that should receive bi-partisan support.

To reform healthcare in America, we need a President who has the leadership skills, will and courage to engage the American people and convince Congress to do what is best for the country. These straightforward reforms, along with many others I have proposed throughout my campaign, will ensure that together we will Make America Great Again.