Republicans can solve the health care crisis — and win politically

When it comes to healthcare solutionstoo many congressional Republicans act like they’re in a political coma. The GOP is coming up with some very exciting ideas, but for now Republicans are on the defensive.

That’s why Democrats are happy. After recent election cycles dominated by inflation, borders and cultural disputes, health care is once again a heated issue. But Democrats have the GOP playing defense, successfully portraying Republicans as enemies of Medicaid, who want to cut or cut benefits to the needy. The internet is full of sob ads, with people asking why their local GOP representative is eliminating insurance coverage for their children who have serious medical problems. Not true, of course. Changes approved last summer included work requirements for able-bodied adults without dependents and more frequent eligibility checks. Contrary to these advertisements, no widows, orphans or sick children were thrown into the streets. But Democrats won’t let facts get in the way, especially given the GOP tongue-tied.

What’s currently tickling Democrats is whether or not Congress will extend the supposed temporary increases in Obamacare subsidies made during the pandemic. Some households with six-figure incomes were eligible. Democrats see these bloated subsidies for a failing program as a stepping stone to a government-controlled, single-payer system. The results of this, of course, would be less care, longer waits for medical services, and the stifling of life-saving and beneficial advances in health care. But some panicked Republicans, acting like deer in headlights, are ready to back down and extend the subsidies.

Here’s what the GOP should do. For starters, they should call their approach “Put patients in charge of paying for health care.”

Get Health Savings Accounts (HSAs). More than 70 million people are covered by HSAs. They embody a basic truth: When people spend their own money, they demand and get better value. Today, however, HSAs are plagued by limitations that undermine their potential. To fix this, HSAs should be available to everyone, whether they have health insurance or not. In fact, individuals should be allowed to purchase their own health insurance policies. Limits on what individuals or employers can contribute should be removed or significantly increased. Contributions will remain tax-free. Restrictions on how HSA dollars can be used should be removed for services such as telemedicine, mental health, and prevention and wellness programs.

Republicans should support making catastrophic coverage once again the foundation of health insurance. Health insurance was never meant to cover colds, routine ailments and essential prescriptions. We need financial disaster plans to cover big, unexpected expenses. Such policies would be much cheaper than what we have now. The average family plan these days costs $27,000. Most households would jump at the chance to get a true catastrophic plan for, say, $7,000-$8,000 and pocket the remaining $20,000.

To help the consumer take control of health care costs, Republicans should be pushing hard and wholeheartedly for what they call Individual Health Care Reimbursement Arrangements. The employee—unlike current HSAs—selects and owns the policy, which can be purchased through the individual market. Employees and employers can make pre-tax contributions. This way, people can take their policies with them if they change jobs or become self-employed. Their policies are fully portable and they, not their employers, own them.

Along these lines, the Federal Employee Health Benefits Program should be open to all. For decades, federal workers have enjoyed a plethora of options from the private sector, rather than the single choice of most private employer plans.

Insurers should be able to compete across state lines.

Republicans should mandate full price transparency from health care providers, detailing all costs and stiff penalties for non-compliance. Healthcare invoices should no longer read like ancient cuneiform tablets.

To strengthen the medical safety net, the GOP should create vouchers that would allow low-income Americans to buy into the same private plans as anyone else.

The GOP needs to snap out of its political paralysis. His political health—and the nation’s medical health—depends on it.