Time to Address America’s Health Care Issues

Now that the government shutdown has ended, it’s time to refocus on improving health care in the U.S.

Even those who supported Obamacare are beginning to recognize that the initiative has its flaws. Contrary to earlier promises of lower premiums, the reality has been quite different. After more than a decade, Obamacare seems to be contributing to the problem rather than resolving it. Premiums are on the rise, deductibles are increasingly high, and enrollees have fewer options, with plans becoming more restrictive.

While increased subsidies may temporarily alleviate some of these premium hikes, they don’t effectively tackle Obamacare’s broader issues. The truth is that health care costs are climbing overall. What is needed now is a strategy to make health care in America affordable—not just to pile on more government subsidies, but truly to lower costs and enhance accessibility for everyone.

President Donald Trump seems to have the right ideas about improving both Obamacare and the wider health system to benefit all.

Regarding Obamacare, Trump has suggested giving beneficiaries their subsidies in a way that allows them to select their preferred plan. This would offer an advantage over the current system where subsidies go straight to insurers. However, the calculation of subsidy amounts also needs to be more transparent and less complicated to prevent further increases in premiums.

Empowering individuals with a health account lets them decide how and where to allocate funds for their health care, since those who control the money make the decisions.

This basic approach is already gaining traction through Health Savings Accounts (HSAs), which many employers and employees are starting to adopt. A survey by the American Bankers Association indicated that last year, there were 39.3 million HSAs in use, benefiting 59.3 million individuals.

Beyond the scope of Obamacare, there are various methods to broaden access to health accounts and make them more user-friendly. The Working Families Tax Cuts bill passed this summer introduced significant changes to make traditional Health Savings Accounts more accessible.

First, it now allows all bronze and catastrophic plans within the Obamacare Exchanges to qualify as HSA-eligible. According to the Centers for Medicare and Medicaid Services, this means around 1.6 million more consumers on HealthCare.gov can benefit.

Second, it clarifies that individuals with direct primary care agreements with providers are still allowed to contribute to an HSA, and they can use their HSAs to pay for these memberships.

Third, telehealth services have been permanently extended as non-deductible.

There are additional policy suggestions that were discussed during the reconciliation process but ultimately excluded from the final agreement.

These suggestions included options like letting low-income individuals contribute more, better aligning HSAs with Flexible Spending Accounts and Health Reimbursement Arrangements, and allowing HSAs to cover gym memberships or access employer clinics. Other proposals aimed to formalize Individual Health Reimbursement Arrangements and encourage small employers to use them. Many of these ideas have had bipartisan support previously and could be revisited.

Thinking on a larger scale, some proposals could greatly enhance health accounts. For instance, Sen. Ted Cruz and Rep. Chip Roy, both from Texas, have introduced the Personalized Care Act, aiming to make health accounts available even if not linked to high-deductible health plans.

Additionally, the Health Out-of-Pocket Expense (HOPE) Act, which has bipartisan backing, would establish new Roth-style accounts to help individuals cover health care costs.

Both pieces of legislation bring fresh ideas to enhance patient control over their health care finances.

While expanding access to health accounts is a promising starting point for reform, consumers also need clear information. The key to this lies in advocating for transparent pricing in health care.

Trump initiated efforts for price transparency during his first term and has continued to support this in his second term. To enhance these initiatives, the Centers for Medicare and Medicaid Services should establish regulations that fulfill the No Surprises Act, requiring health plans to provide “Advance Explanations of Benefits” so that individuals can receive a cost estimate before care is provided. Furthermore, the Department of Labor should be urged to create rules enabling employers to access claims data held by third-party administrators overseeing their health plans.

For far too long, health care pricing has remained unclear. Pushing for transparency is crucial to holding the complex health care system accountable.

Here again, a bipartisan effort is underway in the Senate. Sen. Roger Marshall, R-Kan., and Sen. John Hickenlooper, D-Colo., have introduced the Patients Deserve Price Tags Act, which seeks to give group health plans access to their claims data, mandate public reporting of negotiated rates, costs, and cash prices for specific services, and require itemized billing from providers.

Policy reforms should not focus solely on Obamacare or the 15 million people aided by it. Attention should also be given to the 160 million Americans enrolled in employer-sponsored or union plans.

There are plenty of ideas available to make health care coverage more affordable for all. Many of these have even garnered bipartisan interest. The real question is whether lawmakers will confront the health care industry and act in the best interest of the American people, putting more power in their hands over how they spend their health care money.