Freedom Partners, a group funded by the Koch brothers, has been circulating a memo on Capitol Hill advocating for a series of specific legal reforms, rather than comprehensive legislation, to replace the Affordable Care Act (ACA), according to The Hill.
Among the group’s recommendations are elimination of the ACA mandate, more state control over the marketplace, use of high-risk pools at the state level and increased use of health savings accounts.
Republican Congressmen expressed concerns last week about the timing and content of an ACA replacement plan, according to an audio recording The Washington Post obtained.
Republicans are still struggling to come up with a viable replacement for the ACA, and the leaked audio suggests they are more concerned about disrupting the insurance market than they have admitted publicly. They’re also evaluating options in light of the next midterm elections. They’re right to be worried, considering that 47% of Americans now approve of the ACA, an increase of 6 percentage points since the inauguration.
The Freedom Partners proposal includes some elements that have already been tossed around by Republicans, but within a different framework. Suggesting that another large bill could be just as rife with problems as the ACA to be, the group claims that a series of targeted reforms will fix the healthcare problem one issue at a time.
A major theme of the proposed plan is state-based solutions. Key elements include reinstatement of state high-risk pools and conversion of state exchanges to high-risk pools in order to provide an affordable option for those with pre-existing conditions. In addition, the group advocates for the restoration of regulatory power to the states and allowing them to implement innovative solutions without federal approval.
Here’s where it gets politically tricky: The group suggests giving patients more control by expanding their ability to use health savings accounts (HSAs). There are a couple of problems with this. First, the most vulnerable people—those who had so much trouble affording health insurance in the first place—don’t have a lot of money around to put into an HSA, and they don’t stand to benefit much from the tax breaks an HSA affords. HSAs are also closely linked to the same high-deductible health plans that Republicans have been slamming the ACA over.
Other elements of the Freedom Partners plan include freezing Medicaid expansions, streamlining FDA approval processes, eliminating certificate of need laws, having states reform medical malpractice, giving non-physician clinicians expanded privileges and removing barriers that affect primary care physicians and telemedicine.