Blue Louisa: A blog Covering Central Virginia & national politics from a progressive perspective
Dave Brat in Virginia’s 7th District, and other Republicans, have called on Trump to lessen “burdensome regulations,” and make “it possible for people to once again buy the low-premium coverage they prefer.” (Dave Brat, “We Still Can’t Get Healthcare Right,” March 27, 2017).
President Trump responded by recently expanding “short-term,” inexpensive health plans, known as “skimpy” policies. They became available on the ACA Exchanges in October.
As Dave Brat has called for– these “skimpy” policies increase competition, lessen regulation, but they also gut consumer protections. “Skimpy” plans don’t have to cover pre-existing conditions, or cover 10 Essential Benefits on the ACA– such as ER care, prescription-drugs, mental-health/ substance-abuse counseling, cancer treatments, etc. Some doctors call these “skimpy” policies “junk insurance.”
The Trump administration says “skimpy” plans are good for young/ healthy people. However, young people who get critically injured in car accidents, have substance-abuse issues, acquire youth cancers (testicular cancer, or leukemia), might be left high and dry on “skimpy” plans.
Also, economists warn if younger/healthier people pull out of the ACA– premiums may skyrocket for sick and older folks left on Exchanges. And buyers beware: ‘Skimpy” plans historically have been falsely marketed–promising to cover conditions that in the fine print (few read) are not actually covered.
Dave Brat is also advancing high-deductible Health Savings Accounts (HSAs) to add competition in the healthcare marketplace. These accounts, often invested in the stock market, allow consumers to save for medical care tax free. People who rarely get sick/ injured make out best with HSAs.
Brat’s biggest contribution to healthcare is that he co-sponsored a bill raising dollar limits people can contribute to HSAs each year– up to $9,000 for individuals and $18,000 for families. The higher your earnings, the higher your tax deduction with HSAs, so these accounts clearly favor wealthier consumers.
Abigail Spanberger, also running for congress in the 7th District, wants to increase competition in health care, too. Spanberger wants to maintain coverage of the 10 Essential Benefits in the ACA for all Americans, as well as protections for pre-existing conditions. She also believes Medicare X (which is not universal health care) would compete on Exchanges with private insurers, encouraging them to lower overhead and thus premiums.
Medicare X would be a public option on ACA Exchanges, which consumers could voluntarily buy at any age. This plan uses the same doctor networks in traditional Medicare (the popular seniors government healthcare plan) but would also cover maternity/pediatrics.
Importantly, Medicare X would not touch the Medicare Trust Fund, or change its solvency, because consumers would pay premiums. But Medicare X would be affordable, because unlike private insurers, it doesn’t have high overhead. That’s because it doesn’t have to pay shareholder profits/ big CEO bonuses, or spring for expensive TV ads/ fancy PR.
Importantly, Medicare X would be rolled out in rural areas first, since rural areas have little competition on the Exchanges and many rural hospitals are struggling to survive.
Knowing how candidates define “competition” in healthcare helps constituents be more educated voters.
Editor's Note: This originally appeared in Richmond2Day, and has been reposted here with the author's permission.
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