Healthcare

Republicans believe there are a number of potential areas for common ground to work with President Obama to improve health care for all Americans.  Republicans are promoting commonsense reforms that make health care more affordable, reduce the number of uninsured Americans, and increase quality at a price our country can afford---while making sure that Americans who like their health care coverage can keep it.

Making Health Care More Affordable for All Americans:
More Americans will gain access to quality health care once its costs are brought under control.  The first step in lowering health care costs is to eliminate the unnecessary over-spending in our current system.

To lower the costs of health care, the Republican plan increases fairness in the tax code by extending tax savings to those who currently do not have employer-provided insurance but purchase health insurance on their own.  This provision would provide an "above the line" deduction that is equal to the cost of an individual's or family's insurance premiums.  The plan also provides immediate substantial financial assistance, through new refundable and advanceable tax credits, to low- and modest-income Americans.

The Republican alternative recognizes that many Americans who have not yet hit retirement age but may be changing jobs or have lost a job often face higher health care costs.  To help those aged 55 to 64, the plan increases support for pre- and early-retirees with low- and modest-incomes.

The plan also recognizes that one of the largest obstacles for many small businesses when it comes to retaining current employees or creating new jobs is the cost of health insurance.   The plan allows states, small businesses, associations, and other organizations to band together and offer health insurance at lower costs.

The GOP alternative implements comprehensive medical liability reform that will reduce costly, unnecessary defensive medicine practiced by doctors trying to protect themselves from overzealous trial lawyers.  Additionally, it provides Medicare and Medicaid with additional authority and resources to stop waste, fraud, and abuse that costs taxpayers billions of dollars every year.

This plan creates incentives to save now for future and long-term health care needs by improving health savings accounts and flexible spending arrangements as well as creating new tax benefits to offset the cost of long-term care premiums.  It also gives financial help to caregivers who provide in-home care for a loved one.

Making Health Care More Available & Accessible for All Americans:
The Republican plan reduces the number of uninsured Americans by wisely targeting this population and helping Americans keep health care coverage regardless of a change in or loss of a job. 

The alternative makes it easier for Americans to keep health care coverage regardless of a change in or loss of a job.  In order to increase accessibility, the plan encourages states to create a Universal Access Program by establishing and/or reforming existing programs to guarantee all Americans, regardless of pre-existing conditions or past illnesses, have access to affordable coverage.

The GOP alternative strengthens employer-provided health coverage by helping the 10 million uninsured Americans who are eligible, but not enrolled in, an employer-sponsored plan get health care coverage.  The plan does this by encouraging employers to move to opt-out, rather than opt-in rules.  Furthermore, small businesses will be encouraged to offer health care coverage to their workers by reducing their administrative costs through a new small business tax credit. 

Recognizing that not all high school and college graduates are able to find a job that offers health care coverage after graduation, the Republican solution would allow dependents to remain on their parents' health policies up to the age of 25. The number of uninsured Americans could be reduced by up to 7 million.

The Republican alternative provides flexibility to Medicaid and SCHIP beneficiaries by allowing them to apply the value of their benefit to a health plan that better meets their needs than the one-size-fits-all government program.

Democrats have proposed to establish a government-run "public" health plan.

Government Control:
Government programs constitute nearly half of all health care spending, and increasing government's market clout still further may well lead to rationing of procedures as a way to contain costs. The federal government already imposes price controls on doctors, hospitals, and pharmaceutical companies-leading some Members to wonder when controls on patient procedures will follow.

Spending and Tax Increases:
More than half of the proposed savings for the reserve fund would come by raising taxes still further on those individuals making over $250,000. Health spending will jump from 16.6% to 17.6% of GDP this year alone. Democrats are calling for an additional $1 trillion in new health spending-on top of the more than $150 billion in health spending in the "stimulus" bill.

Massive, Forced Dislocation of Currently Insured Individuals:
Analysis by actuaries at the independent Lewin Group found that nearly 120 million individuals could involuntarily lose their coverage due to a government-run plan.

Reduced Revenue for Providers:
Other analysis by the Lewin Group found that a government-run plan reimbursing at Medicare rates would cause hospitals' total revenue to drop by nearly 5% ($36.5 billion), and physicians' total revenue to decline by nearly 7% ($36.4 billion).

Poorer Coverage and Access:
CBO Director Doug Elmendorf recently testified that traditional Medicare provides a benefit package 15% lower than the standard employer-sponsored plan-one reason why more than four in five Medicare beneficiaries rely on supplemental health coverage. In Medicaid, low provider participation rates often lead to long waits for care, such that low-income Americans would prefer private insurance coverage to Medicaid by a more than two-to-one margin.

Fraud:
A recent series of articles in CQ Weekly highlighted persistent problems with fraud in government-run Medicare-tens of billions per year, not counting fraud never detected.