| The Detroit News
Health care remains of top concern for voters nationwide heading into the November election. Indeed, the U.S. Senate confirmation process for Amy Coney Barrett to the Supreme Court was ripe with questions about how she might address cases challenging the constitutionality of the Affordable Care Act.
Meanwhile, on the campaign trail, both presidential candidates are making their health care case, with Joe Biden promising to build on the law and President Donald Trump promising to fix what’s broken.
This issue matters a lot to Michigan families. Any discussion of it should start with a simple analysis of what can be done at the federal level and what states can also do that could have meaningful, positive impact for patients across the states. Because what we do know is that Obamacare has not been the cure-all for America’s health care woes.
From the beginning, Obamacare caused health insurance premiums to skyrocket and choices to dwindle. Deductibles have soared, too. The Peterson-Kaiser Health System’s brief on the rising costs found that health spending for families enrolled in large employer plans has risen twice as much as their wages over the last 10 years, driven by the dramatic increases in deductibles. The result: A growing number of insured Michigan residents have had to drop coverage or even forgo medical care because they can no longer afford it.
Save action by Congress to substantively reform the law, what can be done? Let’s consider some important executive reforms prioritized by the Trump administration, as well as state-level actions, which signal progress towards addressing concerns over access, quality and affordability of care for Michigan patients.
Perhaps most notable among the Trump administration’s efforts to reform health care is a rule change impacting the flexibility of short-term health plans. Short-term health plans offer temporary, more customized and cost-effective health insurance for up to a year and are renewable for up to three years. However, these plans were restricted during the Obama-era to just six months and were not eligible for renewal, making them an undesirable option for most patients.
The Trump administration’s restoration of these plans to their prior levels of flexibility makes them a popular and viable alternative to costly Obamacare plans or employer-sponsored insurance. This is particularly true for young professionals exiting college and leaving their parents’ health plans, those in between jobs, independent contractors, workers without employer-provided insurance and low-income households. For a family in Detroit, for example, these plans cost about half as much as Obamacare options. That can translate to thousands of dollars in savings per year.
Among other reforms pursued by the current administration are:
►Expanding access to association health plans, allowing small companies to pool resources and offer more affordable coverage to their employees;
►Increasing competition in the prescription drug market, making a significant difference for Michigan seniors on Medicare Part D coverage, who have seen their medication costs drop by 54%;
►Requiring hospitals and health insurance companies to be more transparent with their prices so that consumers can shop around for the best deal.
It’s increasingly clear that reform efforts that depart from one-size-fits all models, increase flexibility and prioritize patient autonomy are steps in the right direction.
Yet, it is equally critical that Michigan residents also explore what elected state officials and candidates for state office have done or would pursue to reform health care in 2021 and beyond. The COVID-19 pandemic has exposed a number of challenges about health care access and magnified opportunities to build on emergency-based reforms that should remain permanent.
Among these are reforms that Gov. Gretchen Whitmer and the Michigan Legislature have both championed during the crisis:
►Elimination of certificate-of-need laws that require health care providers to seek a permission slip from a bureaucratic state board before they can acquire new technology or expand access to care. Many states have some CON laws in place, but Michigan’s are among the most restrictive.
►Removal of certain licensing and scope-of-practice limitations that prevent qualified providers from offering care to the top of their skills and training.
►Expansion of telemedicine, so that Michigan patients can continue to safely and more affordably receive high-quality care from a wider network of medical providers.
Such steps would build on progress made under the Trump administration to reduce costs and expand access to more flexible health coverage options. Indeed, the hard work must continue at both the state and federal levels for Michigan patients to find relief from a one-size-fits all construct and finally sit in the driver’s seat when making critical decisions about their health and welfare.
Lindsay Killen is vice president for strategic outreach and communication at the Mackinac Center for Public Policy. Katie Rodgers is vice president of outreach and government affairs at the Foundation for Government Accountability.