By Robert Weiner and Khel Gordhan
Originally published in the Palm Beach Post
Americans are outraged about cost and insurance denials in the healthcare system. While choosing between providing your children with vital medication or buying a home may be a horrifying thought, for many families with chronic conditions that is their reality.
This frustration culminated in the murder of United Health Insurance CEO Brian Thompson. While this killing should be an outrage to everyone, the denials of insurance companies of people's needs are very real.
Since the bill was enacted in 2010, 50 million Americans have relied on the Affordable Care Act (ACA) for their basic health insurance. In Florida alone, over four million citizens depend on the ACA. The law provides 100 million American families, either through Obamacare or their private insurance, coverage for pre-existing conditions, children to age 26, drug price reductions, and other benefits.
According to the Congressional Budget Office, federal subsidies for health insurance are about $1.8 trillion, or 7% of GDP. Many Florida politicians have spoken out to reform the program. Congresswoman Lois Frankel, representing Palm Beach County, has repeatedly called for ACA reform. Another Palm Beach County resident - President Trump - supported reform of the ACA in an NBC "Meet the Press" interview in December last year and said he would not repeal it unless a cheaper and better alternative were offered. Trump said, "If we come up with a better answer, I would present that answer to Democrats and everybody else, and I'd do something about it."
During RFK Jr's confirmation hearing Jan. 29, when Sen. Raphael Warnock asked RFK Jr. if he would extend the tax cuts scheduled to stop at the end of this year covering rising premiums, he said he "could not commit". Extending the tax cut is the least Trump could do to improve healthcare. However, there are additional pathways the Trump administration could use.
One solution is to promote meaningful transparency on healthcare prices. More could be done to require manufacturers to disclose justifications to increase the price of drugs. This would include forcing them to name the factors contributing to the drug's pricing. Stiffer penalties could also be implemented for hospitals that refuse to comply with price transparency.
Some lawmakers have suggested that the U.S. transition to a single-payer system. Notable advocates include the late Claude Pepper (D-Fla.), the Senator and congressman who supported national health insurance when Harry Truman first proposed it in 1945.
The foundations for such a system already exist, with Medicare and Medicaid. To cover everyone, the government would have to expand those programs to cover all citizens.
Converting to a single-payer system would face significant challenges. For example, a master price list could be influenced by lobbying from insurance companies and healthcare providers, leading to a lack of price reduction. With a universal healthcare system, waiting times for services also have the potential to increase. Favoring this pathway has also become deeply partisan, in the current environment a significant legislative challenge.
To do the possible, the most effective way forward would be to incorporate measures designed to keep insurance companies in check. Preventing insurance companies from abusing AI to accept or reject claims would be a good start, since most people believe their cases are individual and personal. Stricter enforcement of laws preventing insurance companies from leaving patients liable for out-of-network charges during emergencies would also be crucial to this effort. Capping administrative costs would greatly reduce the strain on the system. Putting a cap would remove some of the incentives for CEOs to arbitrarily spike prices.
President Trump should arrange a White House Summit of insurance company CEOs to discuss pricing and access. Such a meeting would have enormous potential to achieve a bipartisan agreement and improve cost-effectiveness. Politicians from Florida have been proven to be forward-thinking leaders when it comes to healthcare reform. Trump's promise to not alter the ACA unless his changes are better and cheaper could actually build a better health care system.
Robert Weiner was chief of staff of the House Aging Committee and Health Subcommittee under Sen. Claude Pepper (D-FL) and was a senior spokesman in the Clinton and Bush White Houses and the spokesman for the House Government Operations Committee. Khel Gordhan is a senior policy analyst at Robert Weiner Associates and Solutions For Change Foundation.
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