Washington, DC – Members of Congress and the president can reach a bipartisan agreement on health care reform if they reject political polarization, embrace bipartisan compromise, and give voters what they want – improvements, rather than unworkable disruptions, to our current system that secure greater affordability and sustainability. That’s the message of a new report released today by members of the Bipartisan Policy Center’s Future of Health Care initiative.
It’s a practical proposal designed to make health care coverage more affordable by lowering costs without adding to growing public health expenditures. It will help stabilize the individual insurance market, end expensive surprise medical bills, thwart anti-competitive practices in the prescription drug and hospital industries, and accelerate the shift from fee-for-service medicine to value-based care.
The report, Bipartisan Rx for America’s Health Care, includes recommendations for congressional action that were developed by 10 of the nation’s leading, yet ideologically diverse, health policy experts including co-chairs former Senate Majority Leaders Tom Daschle and Bill Frist, and Andy Slavitt, and Gail Wilensky, in collaboration with Sheila Burke, James Capretta, Chris Jennings, Cindy Mann, Avik Roy, and the late Alice Rivlin.
BPC’s plan answers voters’ call to tackle rising health care costs, expand access to insurance, and improve quality of care by strengthening and building upon America’s current health care system instead of repealing and replacing the Affordable Care Act or converting to a “Medicare for All”-style system. A recent BPC national poll shows that nearly double the number of voters prefer improving the current system over replacing it.
The survey also found that high out-of-pocket health care costs are a top concern for Americans in the 2020 election. Over the past 15 years, employee out-of-pocket costs increased by 58% while wages only rose by 27%. And average individual deductibles more than tripled to $1,655 in 2019 from $533 in 2009.
Key recommendations include:
- Ending expensive surprise medical bills. Limit charges from out-of-network providers when services are provided at in-network facilities or in emergency room situations for all Americans with private health insurance. In 2017, 18% of ER visits and 16% of in-network hospital stays included at least one out-of-network charge.
- Targeting anti-competitive behavior and excessive billing practices by some hospitals. Limit hospital charges in markets where mergers increase prices if excessive prices are not moderated. Nearly half of all hospital markets are considered highly concentrated. Lack of competition negatively affects health insurance premiums.
- Lowering prescription drug costs by eliminating barriers to competition. Prevent brand name drug and biologic companies from delaying a generic drug entry into the market. Allow states more flexibility in the Medicaid program by giving them the same tools used in Medicare to lower drug costs.
- Reducing out-of-pocket costs for Medicare beneficiaries with high drug expenses. Restructure Medicare’s drug payment design to shift and reduce the financial burden away from taxpayers and beneficiaries.
- Lowering premiums for more of the middle class and stabilizing the insurance market. Expand premium tax credits under the current structure to more middle-income individuals, up to 600% of the Federal Poverty Level, adding a new minimum credit of $750 per household member, establish a reinsurance program for individual insurance in marketplaces, restore cost-sharing reduction payments to stabilize premiums, institute a new auto-enrollment option for states, and promote aggressive marketing outreach to consumers.
- Reduce consumer costs with improved Health Savings Accounts and price transparency. HHS would require providers to post pricing for a standardized list of services, allowing HSA’s enrollees to more easily shop for high-value care.
The latest national health care spending data underscores the need for these changes. According to the Centers for Medicare and Medicaid Services, national health care spending grew 4.6% to $3.6 trillion, or $11,712 per person in 2018, mainly driven by a faster growth in private health insurance and Medicare. Annual spending is expected to grow by 5.5% between 2018 and 2027, reaching $6 trillion by 2027.
“We believe we have advanced good recommendations that are achievable in today’s charged environment. We are humbled to admit that we may not have all the answers to reforming our nation’s current health care system but think our bipartisan policy proposal can be embraced by both parties for meaningful change. BPC’s effort serves as an example for what can be done when policymakers put politics aside and put the health of the American people first,” wrote BPC’s Future of Health Care leaders in the report.
“Sustainable solutions must address consumers’ concerns about the high cost of health care in a way that doesn’t disrupt the way they receive care,” added the leaders. “These fiscally responsible policies would improve coverage and quality while bringing down costs and preserving public and private insurance coverage. They would also improve competition throughout the health care sector.”
“While no member of the group would necessarily support each individual recommendation on its own, collectively, they represent a comprehensive plan on how to balance sound policy and political viability that can break the status quo and strengthen America’s health care system,” concluded the leaders.
BPC’s Future of Health Care initiative includes: former Senate Majority Leaders Tom Daschle and Bill Frist; Andy Slavitt, senior advisor, BPC and former acting administrator of the Centers for Medicare and Medicaid Services; Gail Wilensky, senior fellow, Project Hope and former administrator of the Health Care Financing Administration; Sheila Burke, fellow, BPC and strategic advisor, Baker Donelson; James Capretta, resident fellow, Milton Friedman chair, American Enterprise Institute; Chris Jennings, fellow, BPC and founder and president, Jennings Policy Strategies; Cindy Mann, partner, Manatt, Phelps & Phillips, LLP and former director of the Center for Medicaid and CHIP Services; Avik Roy, senior advisor, BPC and co-founder and president, The Foundation for Research on Equal Opportunity; and the late Alice Rivlin, former senior fellow, Center for Health Policy, The Brookings Institution, and former director of the Office of Management and Budget.