Obamacare is crushing the middle class. Since the law passed, Americans have seen double-digit health insurance premium hikes, increased deductibles and cost sharing, and many lost the insurance plan and doctors they were promised they could keep. Obamacare has given us a system that costs more, and provides less. At the same time, employer mandates have stymied job creation, led to full time employees becoming part-time, and increased costs of health insurance.
The American people made a statement in the 2014 elections. They gave Congress the responsibility of undoing the damage of Obamacare and proposing a better vision of health care in this country. Having spent the last 25 years working as a physician in a public hospital for the uninsured, this continues my life’s work.
The Supreme Court case King v. Burwell provides an opportunity for the United States to move private health insurance in a better direction. If the Court rules in favor of a plain reading of the law, which is to say against the administration, federal subsidies for private insurance on federal exchanges will be illegal. By providing potentially illegal subsidies and offering no backup plan, President Obama has put the American people in a “bait and switch” situation. This is wrong.
Americans deserve a private health insurance system that provides choice, fairness, affordability, access, portability, transparency, along with protection from costly pre-existing conditions. Most importantly, Americans deserve to have the power over their own health care. Our health care system should empower us as free individuals—not limit our options through government controls and mandates like Obamacare.
By listening to Americans’ concerns, many in Congress have begun to put forward alternative visions of health care. The Supreme Court Case King v. Burwell provides an opportunity to transition toward this vision.
This option should include a tax cut or credit to each individual not receiving a subsidy through their income tax for employer-based health care or covered on public health insurance like Medicare or Medicaid. This tax cut/credit would be sufficient to at least cover the cost of major medical insurance protection supplemented with a pharmacy benefit and a health savings account (HSA). It should be fair and be roughly equal to the tax benefit employees receive when they obtain health insurance through their employer.
The tax cut/credit should go directly to the individual, allowing the individual to choose what health care option is best for them and their family. It should be deposited into an HSA so the patient has control of it. The HSA should be reformed to be more flexible, making it easier for individuals to manage their own health care dollars.
States should have the option to enroll uninsured individuals with basic major medical protection coupled with an HSA. This state option would ensure that the individual and society is protected if expensive medical care for an illness or an accident is needed. It would provide families access to basic health care without mandates.
This vision should empower individuals to move between health coverage options without fear of being denied for pre-existing conditions and protected from premium spikes.
Based on the success of Medicare Advantage, when health plans enroll people with expensive health problems they receive a risk adjusted premium. Obamacare has triggered a “race to the bottom” with narrow networks excluding the chronically ill. The alternative would allow insurers to better and more affordably serve the sickest Americans.
At the ballot box, Americans said they want an alternative vision of health care that keeps all the promises President Obama has broken. People should be able to keep their job, keep their health insurance if they like it and keep their doctor. Health care should be less expensive, more accessible, more portable, and of higher quality without raising the deficit. It should eliminate mandates.
We must seize this opportunity and come together to develop a vision that will become a reality.
Cassidy is Louisiana’s junior senator, serving since 2015. He sits on the Appropriations; the Energy and Natural Resources; the Health, Education, Labor and Pensions; and the Veterans’ Affairs committees. This piece originally appeared at The Hill.