While Congress failed to pass legislation in 2017 that would chart a new path for health reform, the Trump administration made important progress through administrative actions to give consumers more affordable choices for health insurance and offer states more options to take care of vulnerable patients with high health costs.
The Biden administration is working to pull the plug on many of these popular and consumer-friendly options as it lures more and more people into substandard health plans subsidized by government.
A few examples:
- Short-term health plans: HHS Secretary Xavier Becerra testified before an Energy and Commerce Committee hearing this week and was asked about short-term plans by Florida Democratic Rep. Kathy Castor. Sec. Becerra agreed with her description these are “junk” plans, and he said HHS is undertaking a review of the Trump rule.
Reversing the rule, which gives states the option of extending eligibility for up to three years, would be terrible policy. More than three million people purchase these plans each year and, for many, they are the only option other than being uninsured.
Liberals want to eliminate this competition and drive more people into ACA plans. Galen Senior Fellow Brian Blase wrote that evidence shows the 2018 rule expanding short-term options not only increased consumer choice of coverage and reduced the number of uninsured but also had no adverse impact on the individual market. States that permit short-term plans have lost fewer enrollees in the individual market, have had far more insurers offer coverage in the market, and have had larger premium reductions since the rule took effect, his research shows.
- Don’t mess with Texas: Texas had been granted a 10-year extension of a waiver that provides “healthcare access for vulnerable Texans,” but the Biden administration pulled the waiver last month. Texas Gov. Greg Abbott is not happy: “Abbott blasts Biden administration decision to block health care safety net for uninsured Texans”
The initial waiver began in 2011, was extended in 2017, and the Trump administration agreed to a 10-year extension this January. The Biden administration pulled the plug because it said there wasn’t enough time for public comment—for a waiver that has been operating for a decade. Clearly the Biden administration is angling to force Texas to expand Medicaid.
“The State of Texas spent months negotiating this agreement with the federal government to ensure to ensure vital funds for hospitals, nursing homes, and mental health resources for Texans who are uninsured,” said. “With this action, the Biden administration is deliberately betraying Texans who depend upon the resources made possible by the waiver.”
Two other examples of incoming fire:
- Transparency: Over the last two years, the federal government took steps through the rulemaking process steps to compel hospitals and health insurers to post their prices to enable better shopping. Brian led this and many other efforts during his tenure at the White House.
But now, he writes in The Hill, “some free-market economists are skeptical that this will work.” He counters that transparency efforts already have increased shopping and pushed prices down. “More than a decade ago, New Hampshire was the first state to establish a website with health care price information. New Hampshire consumers who used that information to shop saved a great deal, with average savings of 36 percent for medical imaging services, for example.”
- Family glitch. Brian’s paper on the “family glitch” is garnering a lot of attention from the Biden administration which apparently is planning an end run around the law to expand subsidized coverage to a segment of the population explicitly excluded. It wants to do this without Congress appropriating the money or statutory authority to act on its own.
Brian writes in Forbes that an administrative fix to the family glitch would displace private spending with government spending and therefore significantly increase federal outlays while making coverage more complicated for families.
It’s a complicated issue but Brian warns: “The most significant concern with any administrative fix is that it would show that the IRS’s enforcement of the tax code is subject to the political desires of the White House and powerful policy advocates rather than compliance with statute. The IRS, along with the Department of Treasury and the Government Accountability Office, extensively studied options to fix the family glitch a decade ago. They determined, as did the Joint Committee on Taxation and CBO, that the law was clear and unambiguous—the affordability of coverage for the purposes of PTC eligibility was a function of the price of self-only coverage and not family coverage.
Nothing with the law has changed since the last time the IRS reviewed this issue.
We are pushing back on all of this, but it times we feel like the Dutch boy who puts his finger in a leaking dike to save his country. We won’t give up.