Putting Lipstick on a Pig
Poor House Speaker Mike Johnson. He needs our pity. According to the WSJ, his battle is to hold his caucus together as vulnerable Members prioritize their own survival. Donald Trump’s approval ratings are not holding up well, and some members of the GOP have decided it’s every man for himself. In fact, four members signed a Democratic discharge petition to extend the pandemic-era Obamacare subsidies.
The GOP is trying to expand consumer choice and address cost by expanding the greater availability of association health plans and health reimbursement accounts that will help more Americans access quality coverage they can afford and use. Herein lies the problem: The GOP plan will not address the crisis of affordability unless it includes policies that expand the supply of providers and services.
Lanhee J. Chen, at the Hoover Institute, explains how, throughout the country, states have adopted anticompetitive policies, like “certificate of need” laws that require authorization to construct new hospitals or expand existing ones, or “certificate of public advantage” laws that exempt certain facilities from antitrust statutes.
Obamacare’s ban on physician-owned hospitals has also abruptly ended new health-facility construction projects, protecting incumbent providers at the expense of a more competitive marketplace. Congress should repeal what it can and incentivize states to address the rest by tying federal funding to needed changes.
Policymakers would be wise to deal with the ways in which some health providers limit patient access to care.
Many states have scope-of-practice laws that prevent nurses and other health professionals from practicing to the top of their licenses. While the physicians’ lobby has advocated for these limits in the name of safety, the evidence supporting their claims is scant.
If Republicans don’t include these policies in their plans, they at least should avoid the temptation to cut a deal and extend Obamacare’s enhanced subsidy regime without reform. Neither will coverage be more affordable nor will it expand choices for patients.
Perhaps most notable, it won’t inoculate vulnerable Republican congressmen from Democrats’ political attacks on the issue. Better to pursue reforms that enhance choices, improve affordability and return the focus to patients first.
Such a decision breathes life into a deeply flawed system, rebukes Mr. Chen. It will not make coverage more affordable or expand choices for patients.
Perhaps most notable, it won’t inoculate vulnerable Republican congressmen from Democrats’ political attacks on the issue. Better to pursue reforms that enhance choices, improve affordability, and return the focus to patients first.
