With the Republicans taking over in January, it is not too late for President Obama to try to do what he knows is right for the American people and “Make Healthcare Affordable!”
Now that the election is over, it is time to stop worrying about the sexual peccadillos of our politicians and focus on pressing issues that really matter, including the state of our healthcare. Insurance rates are skyrocketing. Surprisingly—and alarmingly—very little, if any, of the increases in policy costs will be paid to doctors, hospitals and other medical providers and suppliers. This means that the runaway and unchecked policy costs are higher because we are paying more for insurance companies to decide whether or not they will cover you for the coverage you paid for when you bought your insurance.
The GOP won’t be able to throw out the Affordable Care Act and the expensive policies it created until 2018, at the earliest. That is because the issuance of policies is controlled at the state level. Each state is responsible for approving rates and terms for each health insurance product offered within its borders. Each state’s Insurance Commission approves Insurance products once a year for the following year; and policies that may be issued in 2017 have already been approved. While it may be too late to adjust policy prices, deductibles, and co-pays for 2017, it is still not too late to make arrangements for people to receive money back from insurance companies that do not spend the money they receive on care.
With less than three months left in President Obama’s term, it might be possible to turn that big ship around. Here are three changes which, if authorized, could permit improvements to the health of your health plan and you: First, raise the limits on Health Savings Accounts to $10,000 for 2017. This would allow companies and individuals to set aside money to pay the significant increases in deductibles, co-pays and costs for out-of-network providers that all Americans will experience in the coming year. In addition to raising the limit, uncoupling HSAs from insurance products would also be helpful. This way, people could put a little aside using pre-tax dollars to pay for future medical expenses. Since this would probably benefit every American, it is unlikely we will see any action on this front.
Second, put an end to the real death panels. Regulators are adopting bright-line, age-based rules intended to limit care and create a laundry list of diseases, which, if you get past a certain age, are no longer covered. What most don’t understand, is that supplemental policies only pay for supplemental care. When something is excluded, all expenses associated with the treatment of that excluded medical condition must be borne by the patient. For example, men over 76 who get prostate cancer will no longer be covered for treatment. Too bad! So sad! If you are over 76 and get prostate cancer, your treatment is on you.
Since it is unlikely you will know about any of these cuts until you actually need the service, perhaps it might be wise to publicize these new exclusions, so you will know what you will die from if you can’t afford to pay.
Third, authorize rebates and rescind President Obama’s agreement that prohibits negotiation with drug companies by federal agencies. The ACA requires insurance companies to refund money received from their policyholders if the Minimum Loss Ratio is less than a specific amount. If we redefine Minimum Loss Ratio to equal money in minus money paid out for providers, and refund that money to policyholders if the payout is not at least 60% of the money received, policyholders could see refunds of hundreds of dollars a month. On the prescription side, it is common sense that the government should require all federal contracts with Medicare product and service providers be made with American companies. Since these companies are going to make a lot of money from proceeds paid by American taxpayers, they should pay taxes here. It also makes sense that the government should be allowed to negotiate pricing. For the year 2017, in addition to increases in deductibles and co-pays, the cost of Medicare Supplemental Pharmaceutical Plans has increased 10%. This is in contrast to medical policies, which have increased only 4%. Had the government allowed negotiations, it is likely that pharmaceutical increases would have paralleled those of the Medicare supplemental policies. While the amounts paid for policies next year have been established, negotiating decreases in cost will reduce the out-of-pocket costs that most Americans pay for their drugs.
There are other things that President Obama could do that would help save lives. This would include, instead of closing them, support hospitals that serve underserved and/or geographically remote areas.
In the end, President Obama might want to consider the legacy of the ACA. At its best, supporters believe that it is a failing system that needs to be reformed. Opponents see the ACA as a total failure that needs to be repealed. A few simple changes might make it a system worth preserving.
Minda Wilson, J.D., is a corporate attorney specializing in healthcare. A recognized expert on the Patient Protection and Affordable Care Act, she consults with clients regarding its proper implementation. She is founder of Affordable Healthcare Review, an educational organization providing information about healthcare legislation, its application, and impact. Her book Urgent Care was recently published.