To the Editor:
The 2016 national elections and the failures of the Affordable Care Act have increased the probability of replacing ACA with a rational health care system and have provided the impetus to accelerate the process. However, many would have us believe that alternative healthcare reform legislation is in disarray.
Not so! There are primarily three alternative health care plans developing in Congress, of which HR 5284 has been formally submitted to the House of Representatives. HR 5284 was written by Congressman Pete Sessions (R-Texas) and Senator Bill Cassidy (R-La.), a physician. Pete Sessions is Chairman of the House Committee on Rules, which determines how legislation is presented to the floor of the House for a vote.
Other proposals have been developed by Congressmen Tom Price and Speaker Paul Ryan. Dr. Price is Chairman of the Budget Committee and serves on Ways and Means. He is President-elect Trump’s nomination for Secretary of HHS.
These three powerful Congressmen have some disagreements amongst themselves, but their programs have far more similarities than differences.
For the past four years, I have been privileged to serve on the National Physicians’ Council for HealthCare Policy formed under the auspices of Congressman Sessions. We provided physician feedback to his staff and him as they wrote HR 5284, with consultants such as John Goodman Ph.D (the father of Health Savings Accounts, or HSAs) and others. This council meets annually or sem-iannually and has approximately 90 physician members, some of whom are active in organized medicine, and some who are not.
HR 5284, entitled “ World’s Greatest Healthcare Plan,” or WGHP. is unique and innovative. Some of its features are:
1. Refundable, advanceable, assignable tax credits for all adults based on age, not income - $2,500 for each adult and $1500 for each child, annually. Tax credits are calculated prior to any deductions or other taxes being taken out of a person’s income. Low-income people receive the tax credit as a cash payment (refundable), on a monthly basis (advanceable), and payment can be made directly to a health insurer (assignable). All tax credits must be spent on health insurance, or else they will be terminated. WGHP will eliminate penalties and employer and personal mandates. People will purchase the insurance program they feel is best for them. Most importantly, people will be spending money they have earned and which is protected from taxation, thus keeping the federal government out of their medical management.
2. Roth HSAs. This law encourages patients to purchase high-deductible, basic health insurance in association with a Roth HSA, which is an after – tax HSA, just as a Roth IRA is an after-tax IRA. The after-tax feature allows patients to manage their own healthcare.
3. State-run high risk pools with adequate federal funding, portable health insurance, health status health insurance, disease –specific insurance and selling of health insurance across state lines will all contribute to solving the problem of insuring patients with a pre-existing condition.
4. The federal government will provide block grants to the states for Medicaid. Medicaid patients will have the option to become private patients, buying basic health insurance and an HSA with their tax credit.
5. “Repeal and replace” has become the mantra for dealing with ObamaCare. However Mr. Sessions points out that a vast amount of spending has been alloted for ACA. Repealing ACA also would repeal this authorization, which Congress might not restore for WGHP or any other Republican alternative. He suggests allowing ACA and WGHP to compete and letting the people decide for themselves.
These have been trying times for everyone, but we are gaining rapidly. There are better days ahead.
Robert F. Hamilton, M.D.