Transcript Health Policy - Rice University`s Baker Institute

Health Policy
VIVIAN HO, PH.D.
BAKER INSTITUTE CHAIR IN HEALTH ECONOMICS
DIRECTOR, CENTER FOR HEALTH AND BIOSCIENCES
PROFESSOR, DEPARTMENT OF ECONOMICS, RICE UNIVERSITY
PROFESSOR, DEPARTMENT OF MEDICINE AT BAYLOR COLLEGE OF MEDICINE
Position on Obamacare
NY Times
Bush’s Obamacare Alternative

Provide a tax credit to purchase health plans.

Extend the tax exclusion on employer-provided
health insurance to individual purchasers.

Cap the tax exclusion on employerprovider insurance ($12k individuals, $30k
families).

Increase the contribution limits and uses for
HSAs; Allow low-cost catastrophic health
insurance.
Cruz’s Obamacare Alternative

Expand health savings accounts.

Open insurance markets across state lines.

Delink health insurance from employers.

Allow low-cost catastrophic health insurance.
Kasich’s Obamacare Alternative

Adopt the Ohio model:
 patient-centered
care
 choices
 market
competition
 decentralized
 higher
decision-making
quality
 respect
for individuals
Rubio’s Obamacare Alternative

Refundable tax credits to purchase health
insurance that would increase each year.

Offer federal support for state-based
“actuarially-sound” high-risk pools for people
who have preexisting health conditions.

Open insurance markets across state lines.

Increase the contribution limits for HSAs.
Trump’s Obamacare Alternative

Open insurance markets across state lines.

Provide assistance to people who can't afford to
pay for health care.
Clinton’s Obamacare Adjustments

Require insurers to cap out-of-pocket drug
spending at $250 per month.

Lower out-of-pocket costs like deductibles and
copays.

Increase price transparency so people
understand how much their health care costs.

Enforce anti-trust laws to investigate mergers
and consolidations of providers and insurers.

Strengthen state authority to block excessive
insurer rate increases.
Sander’s Obamacare Alternative

Replace with a “Medicare-for-all” single-payer
system that would provide all Americans with
comprehensive health services.

Government sets reimbursement rates.

No private health insurance, except for
supplemental coverage.

6.2% payroll tax to pay for the program.
Bush on Medicare

Replace current program with premium support
- vouchers to buy coverage from private insurers.

Allow seniors to have Health Savings Accounts.
Republicans on Medicare

Cruz: Raise eligibility age from 65. Replace
current program with premium support.

Rubio: Preserve traditional Medicare for current
beneficiaries. Transition future generations into a
premium-support system.
Republicans on Medicare


Trump: Preserve Medicare by growing the
economy.
Kasich: ?
Clinton on Medicare

Opposes privatization.

Move away from a fee-for-service payment
toward bundled payment in order to reduce
doctors' incentive to order more tests and
procedures.

Require drug makers to provide rebates to lowincome Medicare enrollees equal to those
offered under the Medicaid program.
Sanders on Medicare

Expand the program to insure every American
under a single-payer system.

Close the Medicare prescription drug coverage
gap (also known as the “donut hole”) by 2017, 3
years earlier than current law.
Bush on Medicaid

Has not said clearly what he would do as
president. As Florida’s governor, he privatized
Medicaid. Cost per recipient fell, but utilization
and quality metrics fell too.
Republicans on Medicaid

Cruz: Opposes Medicaid expansion under
Obamacare.

Rubio: Move the program into a state blockgrant system based on population, allowing
states to run the program without federal
oversight.
Republicans on Medicaid

Trump: Says the government must provide
assistance to those in need. "I will make a deal
with existing hospitals to take care of these
people...The government's going to pay for it,
but we're going to save so much money on the
other side...”

Kasich: Expanded Medicaid in Ohio.
Democrats on Medicaid

Clinton: Supports state expansion of Medicaid
under Obamacare. She supports a move away
from fee-for-service payment toward bundled
payment.

Sanders: Until a universal health care plan is
passed, expand and improve the program for
low-income families.
For another perspective…