Last week, Senators Tim Kaine (D-VA) and Michael Bennett (D-CO) reintroduced their bill, the Medicare-X Choice Act, which would create a Medicare based health insurance plan is designed to offer more health care choices and lower costs in all states by 2025. Because the proposed plan is built on the framework of Medicare, in essence it would offer an insurance option that competes with the Affordable Care Act (ACA).
Expanding potential enrollees to all Americans means consumers may leave the ACA, which may impact the risk pool and result in increased premiums. It also impacts providers and access. Medicare requires lower payments paid to providers, and the unintended consequence of the Medicare X Choice Act is that it’s likely to drive many doctors out of the Medicare network.
Instead of competing and disrupting the ACA during a health pandemic, we should address concerns with the ACA and focus on providing health insurance to those in our community who remain uninsured.
According to the U.S. Census Bureau, in 2019, 92% of Americans were covered by either public or private health insurance, so that there was a total of 26 million people who were uninsured during that year, including those who were eligible for a free Medicaid plan. And a January 2021 study issued by the Kaiser Family Foundation, found that of the 15 million people who are eligible for an ACA plan, 4 million people are eligible for a free bronze plan and 4.5 million people are eligible for a subsidized (discounted) bronze plan. What remains are 6 million uninsured people who are not eligible for a free or subsidized ACA plan.
While it is reasonable to consider the faults of the ACA, perhaps setting the ACA up to compete with another federal plan is not the best use of our time and resources; perhaps, we could focus on how we can improve the plan we have and insure more people under it.
Simple Solutions Can Work
Although it is a simple idea, perhaps the federal government should contact the people who are eligible for free and subsidized plans to let them know that they have the opportunity to sign up for an ACA plan?
It seems highly unlikely that 4 million people who are eligible for free ACA plans are actively declining the plan. It is much more likely that they don’t even know they are eligible. Why not give them a call or send them a letter? While it may be a simple solution, it’s unlikely many would turn down free health insurance.
Focus on the Immediate Problem
During the pandemic, the importance of good healthcare has never been highlighted so much as it is now. In a recent Healthinsurance.com survey, 51% would think twice about changing jobs because of their health insurance. The reality is that the majority of Americans are covered by health insurance and are relatively happy with the coverage that they have.
The immediate issue with our health insurance is managing out of pocket costs. While a Medicare-based plan would force costs down (for example, doctor’s office visits), it would also push out providers who rely on a blend of Medicare, insurance, and cash rates for the profitability of their business, which would ultimately create new problems to solve.
To manage out of pocket costs, we can begin to shed light on areas of medical costs that have been shrouded in mystery. In January 2021, hospital pricing transparency took a major step forward by communicating prices of procedures to consumers. Now, hospitals must provide a list of their standard procedures and the prices one can expect to pay in a readable format on their website. The benefit is that consumers can compare those prices against other hospitals in the area to find which hospital meets their medical and budgetary needs.
While we can all agree that American healthcare needs to improve, instead of focusing on setting it up for failure during a time of crisis, let’s improve the system we have. We can implement simple solutions that focus on our immediate needs and bring a tremendous amount of relief to our community.
Jan Dubauskas is a healthcare expert, enthusiastic insurance pro, attorney and mom serving as Vice President of healthinsurance.com
© 2023 Newsmax Finance. All rights reserved.