Ever since Republicans won control of the White House and both Chambers of Congress in November, it became a foregone conclusion that the Affordable Care Act, or ACA, would be significantly repealed and replaced with a new Republican alternative. Although many replacement options surfaced, Republicans have yet to agree on which alternative, or combination of alternatives, should formally be proposed.
According to the Congressional Budget Office, repealing the law without replacing it would result in 18 million Americans being uninsured. By 2026, that number is projected to increase to 32 million.
Introducing the Patient Freedom Act
A new proposal by Senators Bill Cassidy (R-LA) and Susan Collins (R-ME) is lending hope to supporters of the ACA. Sen. Cassidy, a physician by trade, and Sen. Collins are proposing to give states the power to keep their health insurance exchanges that were created under the ACA or replace them with an alternative plan.
Although states would be able to keep their exchanges with this solution, this proposal does away with the financial subsidies and individual mandate which were cornerstones of the ACA. Instead, states would choose for their residents to receive a federal per-capita patient grant or a federal tax credit to help make coverage affordable. This assistance would be funneled into tax-advantaged health savings accounts, or HSA. Consumers would be able to use their HSAs to purchase insurance with fewer restrictions than plans sold under the ACA. Additionally, providers would be required to publish a cash price for services reimbursed from HSAs.
Allowing states to keep the ACA framework would reduce the number of Americans that would need an alternative means for health insurance. Further, it could avoid the lengthy political battles that a full repeal of the ACA would cause. The plan empowers both states and consumers, two fundamental positions of conservative politics.
While Sen. Cassidy and Sen. Collins’ plan seems like a sensible compromise; it is not certain if a compromise is in the cards. The Republican Party might prefer to push their alternative on a national scale. Democrats may also take the stance ofresisting any attempt to undermine the ACA.
To review the full bill, click here.