“Trumpcare” Part I

Patrick Casinelli, RHU, REBC, CHRS, Principal, Employee Benefits
Patrick Casinelli - resized Before we discuss Trumpcare, we should decide what to do with Obamacare – the Affordable Care Act (ACA).  Can we “repeal” the entire law?  Can we “replace” some of the law?  Which part or parts of the ACA work and which don’t?  My answer is YES.  Yes, we can repeal, yes we can replace and yes some of the law is working and yes, some of the law isn’t working.  What should we keep from the ACA, and what should Trumpcare look like?

Keep the individual mandate; all U.S. citizens should have coverage.  The minimum coverage should include some basic coverage for adult and child care, and should include catastrophic coverage for major illnesses and chronic conditions.  The U.S. Government should subsidize tax paying citizens that are down on their luck, but the Trumpcare test to gain and renew a subsidy will need to be tightly managed and strictly upheld.

Wellness needs to be a major part of any plan with disincentives for individuals with unhealthy habits (tobacco, drugs, overweight, high risk hobbies), and incentives for those that quit the unhealthy habits and maintain a healthy standard.  The plans should not be rated for pre-existing conditions, but as noted, plans should include incentives for healthy behavior and disincentives for unhealthy behavior.

The plan should keep the ability to cover dependents up to age 26 on the parents’ plan.  This works and doesn’t add additional cost to the system.  Get rid of the employer mandate.  Healthcare is a highly valued employee benefit and having a quality employee benefit plan helps employers hire and retain the best talent.  Employers know their business best and will do what it takes to keep their business viable and competitive.  Employees are free to decide where to work and if employee benefits are important, they will go work for an employer that offers a great program.

In addition, get rid of all the ACA taxes and all the ACA reporting requirements (W2, 1095-B, 1095-C, etc.).  Taxes and reporting add stress and cost to a strained system.  Trumpcare should focus on controlling the cost of care, making it easier for employers to offer health insurance and for individuals to gain coverage.

Health Care Providers and Prescription Drug Companies, tort reform, uninsured and illegal immigrants are all high cost areas that need immediate attention.  We need to eliminate unnecessary costs and regulations that the government puts on providers and drug companies and allow them to offer their services at a lower price.  Tort reform is needed throughout the health insurance industry.  Unwarranted and unnecessary legal action adds tremendous cost to the system, and must be changed.  The cost for care of the uninsured and illegal immigrants is enormous, but can be controlled.  If uninsured, then the hospital or provider will report you and you will be required to obtain insurance and/or pay a penalty.  If illegal, you will be cared for and then deported to your country of origin.

Look for Trumpcare Part II in an upcoming blog.