These are from John Goodman, a top healthcare analyst now at Goodman Institute.
Goodman has proposed a number of reforms that we think should be considered in any effort to improve or replace Obamacare.
- Offer tax credits to employees. Tax credits are offered to individuals purchasing health insurance through the Obamacare exchanges. If tax credits are extended to the group market, Goodman estimates a 5 to 6 million increase in group-sponsored insurance.
- Allow employers to buy portable insurance. Obamacare imposes substantial fines on employers who buy individually-owned insurance with pre-tax dollars. The 21st Century Cures Act (which did not pass) waived this fine for small businesses, and this waiver could be extended to all businesses, giving employers the freedom to choose between the individual and group markets for their employees.
- Give states the ability to impose a premium tax on group insurance, and use those funds to insure high-cost patients (sicker, pre-existing conditions) in a separate pool so they don’t drive up costs for everyone else as they do under Obamacare.
- Allow free market risk adjustment. Obamacare makes it illegal to discriminate against any group of enrollees based on their health status. This prevents specialized insurers from trying to attract heart patients or cancer patients. In a more open system, providers would compete to attract patients with certain illnesses.
- Allow individuals and families to buy insurance appropriate to their income and health status. As we’ve maintained, people should not be forced to purchase insurance that covers a wide array of services that they don’t want or will never need. If they are forced to do this, we will never get to a consumer led healthcare system.