Obamacare isn’t affordable healthcare. Republicans should put patients and doctors back in charge
The American people are waking up to President Joe Biden and the Democrats’ healthcare failures.
Recent polling by America’s New Majority Project, a project of Gingrich 360, shows that 59% of voters say healthcare has become more expensive under Biden, 59% say health insurance has become more expensive, and 50% say prescription drugs have become more expensive.
In fact, Americans believe that reelecting Biden will increase health costs. Most Americans expect healthcare to become more expensive under a second Biden term, a considerably larger percentage than the number who think it would become more expensive under a second Trump term.
FOR DIABETES PATIENTS, INHALED INSULIN IS SHOWN JUST AS EFFECTIVE AS INJECTIONS AND PUMPS
Clearly, American patients know the government-centric approach of Obama and Biden isn’t working to make healthcare affordable. It is time to return to the approach that has made American healthcare great: putting patients and their doctors back in the driver’s seat.
To avoid the mistakes of 2017, Republicans should focus their efforts not on wholesale replacement of Obamacare but on fixing what is broken. After 14 years, it is clear the law failed in its namesake mission of delivering "affordable care."
Republicans should pledge to enact a series of reforms that will re-center the healthcare system (and healthcare dollars) on the patient: increasing patients’ price transparency, improving patient outcomes, and saving patients money.
The first set of legislative reforms would strengthen and expand former President Donald Trump’s price transparency executive orders for providers and payers. This will put a patient’s right to know out of the reach of bureaucratic whim and make it much harder to weaken.
For patients to fully benefit from price transparency, they need an insurance product that rewards them for finding better deals at lower costs. The traditional system of flat premiums, co-pays and deductibles does not truly incentivize patients to shop around. If they can find a better deal than the insurance company, patients should not be penalized with higher premium rates or cost-sharing just because that provider was out-of-network.
Employers also need transparency into healthcare costs, as they are responsible in negotiating down health costs for their employees. Recent analysis from RAND revealed that commercial payers paid hospitals, on average, 254% of Medicare rates in 2022.
Employers have little insight into the enormous price variation for the same procedures within the same market, with little to no information on the difference in quality of care or the value of procedure. Hidden prices and locked provider networks allow this massive source of health inflation to perpetuate.
This issue is even more acute within Medicare, since the government pays hospital facilities more than outpatient surgery centers for the same services within Medicare. Site neutral payment policies would pay all providers in the same geographic areas the same for the same procedures, saving taxpayers and patients money. This would also remove a powerful incentive toward consolidation by removing one reason why hospitals will buy up independent surgery practices.
In the most significant move for patients, Republicans should modernize Obamacare subsidies to stop showering Fortune 500 health insurance companies — with annual revenues greater than Meta, Microsoft and Alphabet — with billions of taxpayer funds, and instead turn over those dollars to patients.
We can do this by making the subsidies portable, eligible to be applied to any state-approved individual or small group plan approved by the state insurance commissioner, and available for use in individual Health Savings Accounts (HSAs).
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Finally, Republicans can strengthen safety net programs, like Medicaid, by prioritizing care for the working poor and disabled, not as a coverage solution for the greater population. It’s not compassionate to take resources away from those who need them most, in order to spread the resources out over a larger group of people.
But that is exactly what has happened in liberal states, expanding their "safety net" program at the detriment of the working poor who can’t find doctors, suffer negative health outcomes and face long wait times for care. Even worse, recent analysis from Harvard and New York University showed that nearly 1-in-3 enrollees in Medicaid in 2022 didn’t even know they enrolled.
In addition, it is time to establish work requirements in Medicaid. Americans are a generous people and will help their fellow Americans if they are doing their part, but we are under no obligation to help people who are refusing to look for work or go to school to improve their job prospects.
These reforms aim to take power away from big government and insurance company bureaucrats and put patients and doctors back in charge of healthcare. They would make healthcare and coverage more affordable and improve quality of care for every single American.
With the American people now awake to the failures of the Democrats’ promises to make healthcare more affordable, Republicans should aggressively run on these ideas this fall to create the mandate to pass them in 2025.
Newt Gingrich was Speaker of the U.S. House of Representatives from 1995-1999 and a candidate for the 2012 Republican presidential nomination. He is chairman of Gingrich 360.