When it comes to the intense (and intensifying) debate over health care in America, the conversation begins at the top of the alphabet. “A” is for “Access.”
One of the key lessons we’ve learned from the Obamacare experience is that “having health insurance” isn’t the same thing as having access to quality health care.
Millions of Americans are learning the hard way about the tradeoffs between health insurance policies that have no premiums (so-called “free health care”) or those with low premiums but high out-of-pocket costs. The dual promises of “free health care” and the ability to “keep your existing insurance if you want to” were quickly proven to be mere political slogans with no basis in reality.
“The truth,” as Oscar Wilde quipped, “is rarely pure and never simple.” Nowhere is this truer than when it comes to insurance design. Americans are understandably “B” (baffled) about their lack of “C” (choice).
Broader access comes via expanded choice. Some believe average citizens can’t be allowed to choose their health coverage. These are the same voices who initially decried the Medicare Part D drug benefit because seniors couldn’t possibly choose the plan that was best for them. Today Part D has a 90 percent approval rating among those 65 and older.
In August 2018, the Trump administration finalized rules that expand access to so-called “skinny” short-term health insurance plans. These are low-cost, low-coverage options designed for healthy young people — among others — who chose to opt out of Obamacare. They instead prefer to pay the mandated fine, which is generally lower than the price of even a low-cost Obamacare “bronze” level policy.