Cain endorses a health reform plan

[Greenbeard]

In one of the few policy surprises (health care related or otherwise) in last night's debate, Herman Cain did something none of the other candidates have done, as far as I know: he endorsed a full-fledged health reform plan.

Cain went back to a proposal introduced in the last Congress in 2009: the Empowering Patients First Act (H.R. 3400 in that Congress). This was the Republican Study Committee's suggested package of health reforms.

Here's the Congressional Research Service summary of its major provisions with a few additional comments from me in blue.

Amends the Internal Revenue Code to allow a tax credit for qualified health insurance costs to residents of a state that implements a high-risk pool, a reinsurance pool, or other risk-adjustment mechanism. [Two key bits about taxes and health insurance: 1) It creates refundable, advanceable tax credits of $2,000 for an individual and up to $5,000 for a family to buy insurance if they're under 200% of the poverty line (those amounts shrink and phase out between 200 and 300% of the poverty line), contingent upon a state operating a high-risk pool, which Federal block grants would be made available to support; and 2) People buying insurance in the individual market could deduct the amount they paid on health insurance premiums, up to the average value of the national health exclusion for employer sponsored insurance.]

Amends the Public Health Service Act to provide for the establishment and governance of individual membership associations (IMAs) to make available health benefits coverage to IMA members and their dependents.

Small Business Health Fairness Act of 2009 - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to provide for establishment and governance of association health plans, which are group health plans whose sponsors are trade, industry, professional, chamber of commerce, or similar business associations and which meet certain ERISA certification requirements.

Directs that the laws of the state designated by a health insurance issuer (primary state) shall apply to individual health insurance coverage offered by that issuer in the primary state and in any other state (secondary state), but only if the coverage and issuer comply with conditions of this Act. [Allows health insurers to pick a state whose regulations they wish to operate under (the primary state) and to sell insurance in any other state (secondary state) as long as they abide by the rules of the primary state.]

Amends title XXI (Children's Health Insurance) (CHIP, formerly known as SCHIP) of the Social Security Act (SSA) to: (1) require a state CHIP plan to specify how it will achieve coverage for 90% of targeted low-income children; and (2) prohibit CHIP payments for children with family income above 300% of the applicable poverty line.

Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2009 - Sets conditions for lawsuits arising from health care liability claims regarding health care goods or services or any medical product affecting interstate commerce. Establishes a statute of limitations and limits noneconomic and punitive damages. [Beyond the damages caps, it offers federal grants to states to set up administrative health care tribunals to review cases. Also directs the Secretary of HHS to issue best practice guidelines for treatment of medical conditions; no noneconomic damages may awarded with respect to treatment that is within those guidelines.]

Permits a group health plan to vary premiums and cost-sharing by up to 50% of the benefits based on participation (or lack of participation) in a wellness program.

Requires a health insurance issuer to provide claims information, on request, to a plan, plan sponsor, or plan administrator.

Prohibits the Secretary of Health and Human Services (HHS) from using comparative effectiveness research to deny coverage of an item or service under a federal health care program.

Authorizes a state to establish a Health Plan and Provider Portal website to standardize information on health insurance plans available in the state.

Revises the formula for determining rates in the fee schedule for Medicare physician payments. [This is the SGR formula created by the Balanced Budget Act of 1997 that needs to be manually "fixed" every year or so to avoid large, abrupt cuts to Medicare physician reimbursements.]

Sets forth provisions regarding students loans and loan repayment for health care professionals. [Allows the Secretary of HHS to establish a student loan fund with any public or non-profit med schools to provide loans to med students; offers up to $50,000 of loan forgiveness for primary care providers who serve for at least 5 years or 3 years in a medically underserved area.]

Rescinds unobligated balances of certain discretionary appropriations made available under the American Recovery and Reinvestment Act of 2009. Repeals other provisions of such Act, including provisions providing fiscal assistance to states and setting limits on executive compensation. [The significance of this section to health care is that it eliminates the largest investment in health information technology in history.]

Kudos to Cain on hitching his wagon to an actual fleshed-out proposal. Of all the health care proposals the Republicans put forth in the previous Congress, this one isn't my favorite but at least it's a place to begin a conversation.

 

[Greenbeard]

I should probably also note that this isn't just pining for a defunct bill: the Empowering Patients First Act has been re-introduced in the current Congress as H.R. 3000. It seems to be exactly the same, except of course now it repeals most of the Affordable Care Act. At the moment it only has 16 co-sponsors, however, vs. 54 in the previous Congress. But now it has the endorsement of a presidential candidate.

 

[jgarden]

The Republicans had 8 years in the White House (6 of which had GOP majorities in both the House and the Senate) to demonstrate that the private sector could provide Americans with a comprehensive, affordable healthcare system.

What stopped them?