By Ryan Ellis
An emerging axiom in politics is that the political party that is trying to take healthcare choices away from people loses, and the opposing party wins. The conservative House Republican Study Committee seems to have learned that lesson in their impressive new healthcare plan, particularly when it comes to the most important healthcare voters: seniors.
The first order of business in any healthcare plan is to tell people that the latest big ideas from Washington won’t threaten the healthcare they have and mostly like (the devil they know). The Republican Study Committee plan smartly begins with this defense and does not skip over it. House conservatives are committed to protecting seniors over age 65 (as well as the somewhat younger seniors transitioning from the workforce into retirement) from the destabilizing effects of “Medicare for All” socialized-medicine schemes. Seniors know that Medicare for All means much higher taxes on them, a restriction in the doctors they can see, rationing of care, long waiting lines to get medical procedures, and nightmare levels of new government debt.
The first duty of “do no harm” is fulfilled by the RSC plan. As a decidedly un-conservative president once said but didn’t mean, “if you like your healthcare plan, you can keep your healthcare plan.” Seniors on Medicare don’t face any changes under the House conservative blueprint, except additional benefits at no cost to beneficiaries. Near-retirees are given many new options to navigate the difficult period between a working career and retirement.
There are two additional benefits Medicare seniors get under the RSC plan, on top of the current suite of Medicare services, which does not change in any way. The first new feature is that Medicare payment for telemedicine will be much more flexible and easy. Seniors will be able to consult with doctors from the comfort and security of their homes, and Medicare will pay for it. The second benefit is that Medicare seniors will be able to own, use, and contribute to a health savings account, meaning that older people can pay for out-of-pocket healthcare costs using pre-tax dollars.
HSA expansion is a hallmark of any Republican healthcare plan, but the Republican Study Committee plan particularly keeps seniors in mind. In addition to improving how Medicare works with HSAs, the plan expands HSAs in several ways for near-retirees.
The amount that can be contributed to an HSA will increase from $7,000 to $18,000 for a married couple. Seniors over age 55 can make their $1,000 “catch-up” contribution ($2,000 for married seniors) to a single-family HSA. Retirees over the age of 65 can use those HSA dollars to pay for Medicare out-of-pocket expenses, assisted living, durable medical equipment, and other health needs. Younger seniors might use HSA dollars for direct primary care, healthcare-sharing ministries in coordination with a Veterans Administration plan, or however it is most helpful to them.
Whether they choose to use an HSA or not, younger seniors transitioning from a workplace healthcare plan to the years before Medicare eligibility are given greater protections and more options under the RSC plan. People will be guaranteed healthcare coverage as they move from the employer market to the individual market. If they have a pre-existing health condition, they will have access to a guaranteed coverage pool in their state. States as diverse as Maryland, Minnesota, and Oregon adopted these pools and were rewarded with less expensive health premiums than before.
All near-retirees will have access to affordable, individual market coverage as a bridge between work and Medicare. They have that today with Obamacare, but the RSC plan improves that commitment by structuring the guarantee in a way that is far more affordable and tailored to the local needs of seniors in each state. Nothing is taken away from seniors.
On top of this option for guaranteed and affordable major medical insurance, seniors will also be able to consider other forms of healthcare. Association Health Plans would allow seniors to pool together across state lines (either regionally or by a common bond such as their profession) and purchase health insurance as a group. Alternatively, seniors might want to look at a limited-duration health plan that lasts for a period of one year (renewable up to three years) in coordination with health status insurance. Healthcare-sharing ministries are innovative products where members pay each other’s medical bills. There are also direct primary care plans where a senior might want to contract with a health practice on a membership basis.
No matter what a near-retiree opts for (HSA or no HSA, a workplace health insurance plan, an individual market plan, an AHP, a limited-duration plan, a healthcare-sharing ministry, or a direct primary care plan) the RSC blueprint gives older people all the choices they have today and a few more.
Nothing is taken away.
Each senior will be able to choose the healthcare option that works best for them and their family. As a senior transitions to Medicare, they will find that under the RSC plan, they have the same program as before, but with the added benefit of HSA eligibility and telemedicine coverage. The RSC plan is a “yes-and” for older Americans, as opposed to the “either-or” disaster of Medicare for All.
Ryan Ellis (@RyanLEllis) is president of the Center for a Free Economy.