By Sheryl Allenson, J.D.
The Health Policy Consensus Group (Group) released, on June 19, 2018, its Health Care Choices Proposal: Policy Recommendations to Congress. Specifically, the Group recommended replacing Patient Protection and Affordable Care Act (ACA) (P.L. 111-148) spending with block grants to states, explaining that the states should ensure certain steps are taken to ensure that all people, including those that are vulnerable, have choices. The proposal has already met with responses and challenges, some calling it a new plan to repeal the ACA.
Proposal. In its proposal, the Group highlighted problems with the current healthcare system, including higher costs for coverage that is restricted, not expanded, and little, if any choice of coverage in many circumstances. The Group emphasized that it light of problems with the ACA, Congress must act to make changes to the health care system.
By its own assertion, the Group’s proposal would improve choices and lower costs, while still protecting vulnerable Americans. The proposal would also give flexibility to states to achieve those goals, and finally, would ensure that people could "opt into the private coverage of their choice."
The Group highlighted positive attributes likely to occur upon adoption of its proposal by Congress. Moreover, it set out the manner in which "real reform works." For example, the proposal puts more responsibility on the states to use federal money to make insurance more affordable, after the federal government provide a fixed amount of funding to each state. The proposal emphasized the importance of recognizing that the states are best able to design programs for their citizens, noting that the needs across state lines vary, as do the needs throughout the individual states.
Specifically, the Group laid out its proposal for block grants to the states to replace ACA spending and explained how the block grants would work. The proposal would also repeal the individual entitlement to premium and cost-sharing reduction subsidies and Medicaid expansion. The proposal highlights steps to be taken by the states. At the same time, the proposal would nullify mandates, supposedly replacing them with more flexibility for states that would, according to the Group, reduce premiums.
Additionally, the Group’s proposal included action leading to greater access to health savings accounts (HSA). The proposal takes "two key steps" to improve flexibility, to provide wider availability and to give individuals more control over how the funds are used. First, the proposal would approximately double the HSA contribution limits, noting that the current limits are not in line with the rising cost of health care. Additionally, the proposal, if adopted, would make more plans HSA-compatible.
The Group is comprised of "state health policy experts, national think tank leaders, and members and leaders of grassroots organizations across the country." Its proposal has already elicited a response from the press and other groups, some indicating that the effort to repeal the ACA "recycles some of the worst elements of the failed Graham-Cassidy repeal bill—which some experts consider the ‘the most harmful’ repeal bill." Calling the proposal "Graham-Cassidy 2.0," a commentator from the Center for American Progress said that this proposal would lead to the "same disastrous result."
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