The House is expected to vote this week on healthcare reform legislation. The upcoming action comes on the heels of two failed votes in the Senate: one a Democratic bill that would’ve extended COVID-19-era enhanced Affordable Care Act subsidies for exchange coverage and the other a Republican bill that would have helped move our healthcare system in a more patient-centered, market-oriented direction.
What should House Republicans do? They’d do well to focus on making health insurance more affordable. And the GOP has a long list of ideas for achieving that goal.
The bill they released this past Friday includes a number of them. For example, it would provide funding for cost-sharing reduction payments, money that’s designed to help low-income exchange enrollees with out-of-pocket costs. Funding the CSR payments will have the effect of lowering premiums for everyone shopping on the individual market.
The bill will also direct pharmacy benefit managers, the intermediaries who negotiate drug pricing and coverage on behalf of health plans, to provide employers with more detailed data on spending, rebates, spread pricing, and formulary decisions. This transparency will give employers and employees a better understanding of their drug benefits and how to take steps to save money where possible.
House Republicans are also set to build on an executive order from President Donald Trump’s first term, which liberalized access to association health plans. These arrangements allow individuals to band together and purchase health insurance as a group. In so doing, they ensure that beneficiaries enjoy the same scale and bargaining power as large-group employer plans.
The Biden administration ultimately rescinded Trump’s order for allied health professionals. But AHPs remain a sensible strategy for expanding access to low-cost coverage, and they deserve to be on congressional Republicans’ to-do list.
HOUSE GOP RELEASES BUFFET-STYLE HEALTHCARE PROPOSAL AS LEADERSHIP LOOKS TO UNITE CONFERENCE
As a strategy for reducing the cost of coverage, both these policies stand in stark contrast to the Democratic alternative, which begins and ends with the extension of the enhanced subsidies put in place during the COVID-19 pandemic. That approach would cost taxpayers tens of billions of dollars, perpetuate fraudulent exchange enrollment, and simply mask the health insurance affordability crisis brought about by Obamacare.
House Republicans now have a chance to bring that crisis to an end.
Sally C. Pipes is president, CEO, and Thomas W. Smith fellow in healthcare policy at the Pacific Research Institute. Her latest book is The World’s Medicine Chest: How America Achieved Pharmaceutical Supremacy — and How to Keep It. Follow her on X @sallypipes.
