There is much to like about the Republican legislative agenda released late last week by House Minority Leader Kevin McCarthy, particularly on health policy.
Known as the "Commitment to America," the plan promises to foster a healthcare system that delivers high-quality personalized care, to invest in breakthrough medicines, and to drive down prices through transparency, competition and choice.
Critics of the agenda have condemned it as vague, implying that the GOP lacks concrete reforms that can fulfill its lofty ambitions. Nothing could be further from the truth.
Take the Commitment's promise to "[p]ersonalize care to provide affordable options and better quality, delivered by trusted doctors and hospitals." This is something Democrats have failed to do. Thanks to Obamacare's onerous insurance market regulations, patients now have very little freedom to purchase coverage that meets their unique medical needs.
Consider the law's essential health benefits mandates, which force insurers to cover the same slate of services and procedures, regardless of whether patients want or need such coverage. These rules have not only made the insurance market more homogeneous — they've also effectively banned basic, low-cost health plans.
Coverage with rich benefits is expensive. One of the only ways insurers can dial back costs is by including fewer doctors and hospitals in their networks. Nearly three-quarters of exchange plans feature these narrow provider networks.
Republicans could undo some of this damage — and fulfill their promise to deliver more personalized, affordable care — by rolling back the insurance regulations put in place by Democrats. This would help bring about the diverse insurance market that answers to the needs and preferences of patients — not the whims of federal bureaucrats.
The Commitment to America also seeks to "[l]ower prices through transparency, choice, and competition." Expanding the availability and use of health savings accounts, or HSAs, would spur competition throughout the healthcare market — and drive down prices and improve quality in the process.
When patients pay for their care with money they control, they have a real incentive to shop around for the highest-value, lowest-cost options. Providers have to compete for their business, rather than relying on an insurer network to deliver patients to them.
Another stated goal of the Commitment to America is to "[i]nvest in lifesaving cures." There are many ways to promote drug innovation. They all start with reversing the Democrats' destructive prescription drug price controls.
Passed into law earlier this year as part of the Inflation Reduction Act, the scheme gives Medicare the power to set prices beginning in 2026 on 10 drugs covered under Part D. That figure would eventually rise to 20 drugs in 2029 under Parts B and D. That amounts to defunding an industry that's in the business of saving lives.
It's possible to make drugs more affordable without jeopardizing medical research. Specifically, the GOP could address the behavior of insurers and pharmacy benefit managers, which bear significant responsibility for inflating patients' out-of-pocket drug costs.
PBMs extract discounts and rebates from the drug industry each year in exchange for placement on their insurer clients' formularies, or lists of covered drugs. They keep most of those rebates for themselves.
Requiring insurers and PBMs to share these rebates with patients — as West Virginia's Republican Gov. Jim Justice recently did through the state's so-called "share the savings" reform — would help more Americans pay for their medicines and ensure that pharmaceutical companies generate sufficient revenue to invest in the next generation of medical breakthroughs.
For too long the conventional wisdom has been that health care is an issue that advantages Democrats. But as the Commitment to America points out, Democrats have dominated the national healthcare conversation for over a decade. Their slow-moving government healthcare takeover has coincided with falling life expectancy, rising prices and a disruption of the prescription drug market that will harm innovation.
The GOP is proposing to hold Democrats to account for these failings. We'll soon find out if voters will embrace a brand of healthcare reform that empowers and trusts them to look after their own health.
Sally C. Pipes is president, CEO, and the Thomas W. Smith fellow in healthcare policy at the Pacific Research Institute. Her latest book is "False Premise, False Promise: The Disastrous Reality of Medicare for All," (Encounter Books 2020). Follow her on Twitter @sallypipes. Read Sally Pipes' Reports — More Here.
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