CHANGES NEEDED WITH AMERICAN HEALTHCARE ACT BILL BEFORE SIGNED BY PRESIDENT TRUMP

The American Healthcare Act bill is a partial repeal and a partial replacement of Obamacare.
There is a need to pass the bill through Congress via reconciliation so that only 51 US Senators are required for passage of the bill through the Senate.  It will be too difficult to pass the bill needing eight democratic US Senators under the current Senate rules. We need the mandate and taxes of Obamacare repealed in any manner that works.
     However, even with the current Senate reconciliation rules, the following 5 changes should be included.

1. Medicaid  expansion above the federal poverty level should cease January 1, 2018. The phaseout of Medicaid expansion can proceed over the next three years as outlined in the current American Healthcare  Act bill.
2.  Repeal all taxes including the Cadillac tax.
3.  The tax credit portion of the bill can be improved by using a combination of age and means testing. For those who are below 250% of the federal poverty level- they would qualify for tax credits. As outlined in the American Healthcare Act bill-the age groups are separated to less than 30 years of age and then every 10 years to over 60 years of age.  Then according to eligibility and the age group and size of family, the current house bill can be utilized with tax credits ranging from $2000-$14,000 a year.  The Health and Human Services Secretary should also be given the discretion to change those numbers within a 20% range yearly; so that a gradual phaseout could occur in the future without having to pass another bill.
4.  Since many Americans do not have health savings accounts, healthcare premiums, whether with insurance companies or with providers directly,  should be allowed to be paid with pretax dollars. This would be allowed for those individuals with health savings accounts less than $10,000 or families with health savings accounts less then $20,000. This would help decrease the amount of tax credits needed  and decrease the amount of federal tax dollars  needed for this assistance.
5.   Charity Care should be available for all those who are under 250% of the federal poverty level.  This allows all providers to give charity care  up to 10% of their gross revenue yearly.  The  provider would use then use the Medicaid fee for the procedure or billing code for their charity care tax deduction. These deductions would be all pre-tax deductions just like corporations and individuals use for their charitable deductions.  This will also help decrease the amount of tax credits needed and decrease the amount of federal dollars needed for tax credits.

 After passing the American Healthcare Act bill, Secretary of Health and Human Services, Dr. Price can then use his authority from the prior ACA bill  to decrease regulations, promote incentives for transparency and provide for insurances to be available across state lines.  Other healthcare reform issues will have to be addressed later this year or next year such as malpractice reform and others as I outlined in my previous blog in January of this year. We should all pray for Congress to achieve these much needed healthcare reforms.