April 9, 2019 | Rosemarie Day

MedPage Today: Conservatives: We Do Have a Healthcare Plan

“Critics of the proposal say it will harm low-income patients. “The plan stipulates that at least half of a state’s grant funding would be used to provide coverage for low-income populations,” said Rosemarie Day, a healthcare consultant in Somerville, Massachusetts, in an email. “This is far less than what the ACA’s funding is for low-income people now, which is in the form of Medicaid expansion (which apply to people earning less than 138% of the federal poverty level [FPL]) the individual market subsidies (which apply to people earning less than 400% of the FPL, with the poorer receiving more subsidies), and cost-sharing subsidies (already not paid out).”

In addition, “The plan would make it easier for providers to not accept public insurance, and thus make health care services less attainable for those on Medicare and Medicaid,” she said. “If more people are privately insured, providers would feel less of a need to contract with public insurers.” And, she said, “The plan would also be bad for the sick in that there would be much more freedom in terms of plan design (eliminating the 10 essential health benefits and introducing other flexibilities), which means healthy people may not have the coverage they need when they do get sick. And going back to depending on high risk pools as a solution is really not a solution – most were chronically underfunded in the past and had huge wait lists.”

Day, the healthcare consultant, did like the proposal’s plan to allow states to incentivize insurers to offer discounts for continuous coverage, because “[it] would incentivize people to remain in the market, which could conceivably lead to higher coverage rates as well as more investment in long-term health from payers and providers.” She also liked the proposal’s support for health savings accounts, which she called “a good option for consumers (those who have the money, anyway).””

Read the full article here.