Coloradans are feeling the effects of a broken health care system now more than ever. A recent article in the Glenwood Springs Post Independent profiled a woman in Garfield County who is now choosing to forgo health insurance rather than pay for a plan that costs $1,000 in monthly premiums and comes with a $6,500 deductible. She says, “You add it all up and that’s almost $20,000 a year. Health insurance for someone in my situation – I’m in good health, I have some savings – is just not a smart economic choice.”
This woman’s situation is not unique.
As the House has worked towards a plan to repeal and replace Obamacare, my focus has been on the cost of health care, because monthly premiums that exceed mortgage payments and $6,000 deductibles are not sustainable. My Republican colleagues in Congress agree that we must fix the health care system and lower health care costs for our constituents, but there are varying viewpoints about how to proceed. This is why the American Health Care Act (AHCA), one part of the three-pronged strategy for repealing and replacing Obamacare, was not brought to the House floor for a vote a few weeks ago.
Since the AHCA was originally introduced, we have been working to improve the bill to ensure the final product reduces health care costs, provides options for the most vulnerable individuals in our communities, and produces better health outcomes for our families. As this work continues, there are a number of policies that I would like to see included:
- Repeal the individual and employer insurance mandates: the individual insurance mandate was meant to incentivize young, healthy people to purchase insurance to expand the insurance pools and balance risk. It was also meant to cut down on the number of uninsured people who show up to hospitals with a medical emergency. Last year, 6.5 million people chose to pay the fine to forgo insurance rather than sign up for a plan. The individual mandate is not serving its intended purpose and should be repealed. The employer insurance mandate creates a disincentive for small business owners who wish to grow and create jobs in their communities. The federal government should be in the business of making it easier for entrepreneurs to create jobs and economic opportunities. Arbitrary policies that get in the way if this should be repealed.
- Prohibit insurance companies from dropping beneficiaries: over the past few months, my team and I have spoken with many people who are concerned that once Obamacare is repealed and replaced, their insurance companies will be able to drop their coverage if they have an accident or develop a serious illness. I firmly believe that no insurance company should be able to drop an individual who has maintained continuous coverage. Insurance is meant to be a safeguard against those types of situations – if that’s not how it functions, what’s the point in having it in the first place?
- Ensure individuals with pre-existing conditions have access to affordable health insurance: prior to Obamacare taking effect, the Health Insurance Portability and Accountability Act (HIPAA) prohibited insurance companies from denying insurance to any individual who transfers between group markets. I would like to see these protections extended to the individual market, so as long as someone maintains continuous coverage, they cannot be denied health insurance because of a pre-existing condition.
- Provide states with resources to develop tools to stabilize their insurance markets and create systems to serve their unique populations: the last seven years have shown us that a federally-run health care system does not work. We must give states the ability to meet the needs of their unique populations. The AHCA developed a State Innovation Fund that would provide states with federal resources to develop things like high-risk pools and reinsurance programs.
- Allow states to define essential health benefits and give insurers more flexibility in plan offerings: prior to Obamacare, essential health benefits were regulated at the state level. Colorado had set essential health benefits to include: maternity and newborn care, prescription drugs, rehabilitative services and devices, some laboratory services, preventative services, some pediatric services, mental health services, and some substance use disorder services. Of course, many insurance plans offer more than these services, but they are the minimum benefits a plan must cover in order to be sold in the state. Returning the power to set essential health benefits back to states will help allow insurance companies to craft plans that meet the needs of communities and drive down overall costs.
- Provide individuals and families with more tools to manage their health care costs: health savings accounts (HSAs) and flexible savings accounts (FSAs) give individuals and families more flexibility in the way they spend their health care dollars. We should make it easier to use these tools by raising the caps on HSA and FSA contributions, as well as allow spouses to make “catch-up” contributions to the same HSAs.
Additionally, I believe that giving associations and small businesses the opportunity to band together to establish health plans will help provide consumers with more health care options. For example, many people in the West are part of a rural electric co-op – why wouldn’t these co-ops be able to join together and establish an association health plan? That’s a good question, and the House recently passed two bills to help make this happen: the Competitive Health Insurance Reform Act (H.R. 372) and the Small Business Health Fairness Act (H.R. 1011). The bills will help associations establish health plans that can be offered to members in multiple states.
I have said since the beginning that repealing and replacing Obamacare will not happen overnight—and it should not be rushed through under an artificial deadline – but I will not sit idly by while families in Western Colorado continue to face exorbitant health care costs. Coloradans deserve better, and I will not stop working until they get it.
Congressman Scott R. Tipton represents Colorado’s Third District. He serves on the House Committee on Financial Services and the House Committee on Natural Resources. He is Vice Chairman of the Financial Services Subcommittee on Oversight and Investigations Tipton is the Executive Vice Chairman of the Congressional Western Caucus and Co-chairman of the Congressional Small Business Caucus.