1.First, repeal Obamacare entirely. One simple law that ends it, perhaps with the stipulation that some of its provisions be phased out rather than abruptly halted. The phasing must be complete by the end of Trump’s first term, however, or you are inviting disaster.
No "perhaps" about those stipulations. Setting aside the recently-demonstrated fact that simple repeal is politically impossible, the disruption caused by
not phasing things out will result in actual people suffering actual harm through lack of coverage. That's bad for the people involved, and really bad politics.
A more politically workable solution for the people most likely to be hurt by repeal is -- sorry, folks -- some form of replacement for some segment of the population.
2.Mandate insurance be portable, meaning it isn’t tied to your employment. If you lose your job, you don’t lose your health insurance. You have the ability to continue the coverage without interruption as you find new work.
Easy to say, hard to do. Most people are covered under company-subsidized health plans, where the heavy lifting for negotiating coverage, premiums, and formularies is shouldered by large corporations. Transitioning from that model to portable individual policies will disrupt how companies manage compensation; require significant changes to tax policies; and may very well lead to higher costs for a lot of people because they'd be moved into smaller risk pools, and individuals don't have the same negotiating heft as, say, Lockheed-Martin or WalMart. It would take a few years for the disruption to settle out.
3.Mandate insurance be continuous and renewable, meaning insurance companies are not allowed to jack up your rates or costs because you get sick – that defeats the whole purpose of insurance. If you have been paying a rate for your coverage, but then get very sick, you must be allowed to renew your insurance at the same premium you’ve been paying. This rewards and encourages responsibility.
The "rewards and encourages responsibility" bit is advertising twaddle and can be ignored. The meat of this suggestion is that insurance companies are required to pay for pre-existing conditions. This is great for people who have pre-existing conditions and I actually support some form of the idea; but it's also the same requirement that has made Obamacare plans so expensive.
Moreover, a plain reading of this point suggests that once a person gets sick, he'll effectively be unable to shop around unless the "fixed premium" provision is made to apply to other insurers offering comparable plans.
4.Open up the insurance market across state lines – competition will decrease costs as it always does.
Maybe. It would perhaps increase the size of the various risk pools, and therefore reduce costs. But the "competition will decrease costs" line is again advertising twaddle. Competition may decrease premiums, but as we've already seen with Obamacare that reduction is most likely offset by increased deductibles and limitations on coverage.
The only plausible way for reducing the cost of health insurance, is to somehow address the costs of the medical care those plans are paying for. So as has been suggested, things like Tort Reform are essential. I'd say that finding ways to simplify the terms and use of insurance is likewise necessary.
5.Allow people to buy low-cost catastrophic coverage, including the use of health savings accounts.
This is fine.
This is the way forward and it can be done with full Republican support in Congress if leadership would leave their pride behind and get to work. Never mind your feelings and passions about whether Cruz would have been a better choice than Trump, whether he could have beaten Hillary, or any of that. It doesn’t matter.
It's a place to start the deal-making. It's not a workable plan.
