Congressional Brief: NCPA Health Reform Agenda

Congressional Briefs | Health

Wednesday, May 11, 2016
by Devon Herrick

Goals of Health Reform

Health reform must replace Obamacare with increased flexibility in health plan design; tax fairness regardless of where Americans get their health coverage; increased access to primary care by removing barriers to innovative medical practices and services; reform of hospital regulation to better serve patients; reduced costs through price transparency to boost competition and innovation in medical services and prescription drugs; strengthened Medicare, Medicaid and Veterans Health that better serve the needs of patients; and changes in the financing of medical care so that individuals have control over their health care dollars and the means to pay for medical care over their lifetimes.

Reform Health Insurance Markets to Better Serve Americans

Repeal Obamacare. Congress should repeal the individual and employer mandates and taxes of the Patient Protection and Affordable Care Act (ACA). In addition, Congress should repeal regulations that prevent insurers and employers from designing affordable health plans, including the “essential benefits” package, and allow consumers to choose limited benefit plans and catastrophic coverage.

Increase Health Coverage Flexibility. Congress should repeal the ACA regulations that prevent insurers from fully adjusting individual premium rates to reflect known health risks. Instead, Congress should restore the right to renew coverage if an applicant has maintained insurance with no gaps of more than 63 days (COBRA) and insurers should be allowed to sell multiyear coverage. This would also allow individuals to keep their portable health plans regardless of employment. A national market in addition to state-regulated markets would allow insurers to sell policies across state lines, resulting in competition among states to reform overly-restrictive state mandates. Health plans should be allowed to build in cost-containment tools such as Health Savings Accounts, cost-sharing and reference pricing — which allows health plans to set the amount they will reimburse for a particular procedure. This would give providers an incentive to charge no more than the reference price or risk losing customers. Insurers and health plans should also be allowed to maintain exclusive provider networks, require competitive bidding and selectively contract in order to obtain the best prices.

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