The U.S. health care system was broken and expensive before the novel coronavirus pandemic, the Texas Public Policy Foundation (TPPF) says.

And now, “COVID-19 has exacerbated the brokenness and lack of affordability in healthcare,” David Balat, director of health care initiatives at the TPPF, told The Center Square.

Before Gov. Greg Abbott took steps to close businesses deemed nonessential and suspend elective surgeries to ensure enough hospital beds remained open to treat COVID patients, Balat and several legislators proposed reform measures.

“Texans are largely frustrated by the way we pay for and deliver health care services,” Balat said. “Costs are skyrocketing, people are paying tens of thousands of dollars before coverage kicks in, insurance companies are failing patients, and too many communities are seeing their medical providers close up shop.”

A former hospital administrator, Balat is working with state and federal legislators to put patients in charge of their own health care and lowers costs.

The Affordable Care Act was touted as a way to make health care more affordable and accessible, but it did neither, U.S. Rep. Chip Roy, R-Kerrville, argues.

The ACA “crippled the ability for Americans to gain access to healthcare in the name of health coverage,” Roy said, with prices, spending levels and bureaucracy continuing to increase.

In January, Roy introduced the Personalized Care Act, with U.S. Reps. Mike Johnson, R-Louisiana, and Andy Biggs, R-Arizona, and U.S. Sens. Ted Cruz, R-Texas, and Mike Braun, R-Indiana.

The Personalized Care Act expands Health Savings Accounts, a mechanism to be used for direct medical care, health care sharing ministries, medications, and insurance premiums.

Roy has been working with his colleagues on the Republican Study Committee to reform the existing system so that individuals can find a doctor online or through a directory like they would find a mechanic to get an oil change for their car.

“The concept is built upon a foundation of expansive health savings with equalized tax treatment for individuals and businesses, state-administered backstops through ‘guaranteed coverage pools,’ and most importantly, the elimination of Obamacare’s Title I mandates,” Roy said.

The TPPF has proposed seven policy recommendations to improve health care price transparency, increase options to help patients cover medical expenses, and expand greater access to health care professionals. The proposals respond to current health care challenges presented by the coronavirus restrictions as well long-standing problems in Texas’ health care system, Balat said.

Reform focuses on price transparency, an issue that nearly nine out of 10 Texans say should be mandatory for medical providers to follow for non-emergency procedures and treatments before performing them, TPPF says. Lawmakers would have access to the negotiated rates between the government and health care vendors, according to the plan, to ensure greater transparency.

At a recent health care reform teleconference, state Rep. Tom Oliverson, R-Houston, said, “the main problem driving access to health care right now is affordability. We have plenty of health care in this country and in this state but the reality is that for a growing percentage of Texans, it becomes unaffordable.”

Oliverson said there are two approaches to solve this problem, “you either take the responsibility away from the individual and give it to government and let the costs continue to escalate,” similar to the Medicaid single payer system, or “we do what Americans do best. We inject some free market thinking into our health care system and require transparency and require providers to compete on price and quality.”

One of the benefits of the coronavirus shutdown has been the expanded use of telemedicine, which should not end when the shutdown does, according to another policy recommendation.

“Telemedicine has proven to be a convenient and safe alternative to traveling long distances to see a doctor,” Balat said.

TPPF is urging the state Legislature to permanently eliminate regulations waived during the shutdown in order to increase telemedicine access and lower costs.

Other policy recommendations include expanding the state’s medical licensure reciprocity, allowing physicians to dispense medicine, continuing the federally qualified health center grant program for rural communities, and creating a pilot program to allow Medicaid patients access to direct primary care options, broadening medical cost-sharing options.