The Affordable Care Act (ACA) “replacement” proposal that Republicans in Congress have been working on was presented by Speaker Ryan recently.
Here, experts break down the top three things to know about the GOP plan.
1. Expansion of the use of health saving accounts (HSAs) coupled with high-deductible health plans (HSA-HDHP) is a top priority.
Policies the plan calls for include:
- Increasing the maximum HSA contribution limit;
- Allowiong both spouses to make catch-up contributions to the same HAS; and
- Establishing an administrative fix for expenses incurred prior to establishment of HAS.
“While HSAs are a popular tool to engage patients to be better healthcare consumers, existing HDHPs provide pre-deductible coverage for a few preventive care services, limiting their attractiveness,” says A. Mark Fendrick, MD, professor of internal medicine in the School of Medicine and a professor of health management and policy in the School of Public Health at the University of Michigan. “Policymakers should consider proposals that increase the flexibility of HSA-HDHPs, such as allowing plans to exempt certain services from the HDHP deductible—such as prescription drugs to prevent the onset of a chronic condition—and increasing the annual HSA contribution limits.”
Managed Healthcare Executive editorial advisor Don Hall, principal, Delta Sigma LLC, says that there are two problems with HSAs and HDHPs. “First, few people will actually fund them appropriately and second, results of the use of this type of plan design is that needed care is delayed worsening outcomes and increasing costs,” Hall says. “This has been demonstrated in the high-deductible plans offered through exchanges.”