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A 2016 prescription for health care reform

In the campaign season thus far personalities have overshadowed policy positions in both media coverage and personal discussions of the candidates. New data on the costs of the Affordable Care Act, also known as Obamacare, suggest this is one policy debate that deserves more detailed answers from the men and women who would be president.

Health care premiums will cost more this year in 49 out of 50 states, according to a state-by-state analysis done by Freedom Partners. Mississippi is the sole exception. Iowans buying individual insurance in the individual marketplace will pay, on average, 22 percent more this year. That’s double the increase they were hit with in 2015. So much for “bending the cost curve down,” as we were promised when Obamacare was muscled through Congress.

But at least everyone’s got coverage, right?  Wrong. While over 45,000 Iowans signed up for health plans via the exchange in 2015, at last count, over 10 percent of those folks never paid their first premium or dropped their coverage altogether.  Tens of thousands more never signed up at all.

As is the case in the nation at large, most of the so-called gains in coverage in Iowa have been from a vast expansion of Medicaid in the state — with many of the new enrollees being people who lost their old coverage under Obamacare. Unfortunately, Medicaid expansion does not equate more of Iowa’s families getting quality health care. Several studies indicate that Medicaid patients experience worse health outcomes than patients with no coverage at all.

Nationally, Obamacare has increased federal spending by nearly $2 trillion, added over $1 trillion in new taxes, and cut more than $800 billion from Medicare. Three years in, Obamacare has proven to be unaffordable, unworkable and unfair.

The only way to fix it is to repeal it and start over. Unfortunately, while many candidates have backed the “repeal” part of the equation, few have addressed how they would start over.

They would do well to follow the advice of The Heritage Foundation. The think tank’s soon-to-be-released policy handbook for candidates, Solutions 2016, lays out the “then what” reforms candidates should be talking about:

  • Remove regulatory and policy obstacles that discourage choice and competition.
  • Encourage personal ownership of health care by reforming the tax treatment of health care.
  • Transform health care coverage for low-income Americans by reforming Medicaid as a true safety net and glide path out of poverty.
  • Modernize Medicare program to meet the demographic, fiscal, and structural challenges that threaten to bankrupt the system.

A June 2015 Heritage analysis showed that if Iowa were exempt from Obamacare’s federal insurance requirements, health care premiums could drop by $1,068 for 21-year-olds and by $468 for 64-year-olds.  In fact, getting rid of such costly insurance requirements could lower the costs for all Iowans with individual or small-group health insurance.

Empowering individuals to control their health care dollars and decisions is the right prescription for health care reform. Unlike the heavily regulated markets created by Obamacare that drive up costs while driving out choice, patient-centered policy solutions would give Americans access to a wide variety of plans and insurers and the ability to choose a plan and, and yes a doctor, that best suit their needs.

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