Nowhere is President Obama’s perfected use of the “false choice” rhetorical technique more apparent than when he misrepresents critics of his inaccurately named Affordable Care Act as offering only either/or ultimatums when, in fact, they articulate reasonable—and better—options.
Alternatives, however, can’t even be heard, much less seriously considered, until we get control of health-care policy out of Washington—including out of the Supreme Court—and back into the states.
Let’s give state policymakers the opportunity to implement approaches that make their state’s health-care markets competitive, thus lowering costs, increasing the availability of different types of plans and incentivizing—rather than forcing—people to purchase insurance.
This is certainly a viable alternative to Kentucky’s Obamacare policy known as Kynect, which was created by executive order, resulting in 75,000 people purchasing subsidized insurance plans that must meet Washington’s costly and unreasonable mandates and regulations.
Even though the Supreme Court has ruled that subsidies are allowed for Obamacare participants purchasing insurance through federally run exchanges—that should not end the search for a better path.
It’s likely, for example, that developing state-based policies offering more choices and flexible plans than currently available through Obamacare or Kynect will result in younger, healthier people purchasing insurance in larger numbers.
States could attract this Obamacare-coveted group by allowing individual insurance policies that include tax-free Health Savings Accounts attached to catastrophic plans with high deductibles.
Such accounts could be used for everyday medical expenses like routine check-ups or preventive measures like gym memberships while also including affordable coverage for major medical conditions.
“We don’t use our car insurance to pay for oil changes and minor repairs; instead, it’s reserved for wrecks and major situations—so health insurance shouldn’t be used to meet everyday health-care needs when there are other, less-costly ways available,” said University of Kentucky Economist John Garen, Ph.D., who frequently attends the Cato Institute’s annual health-care conference in Washington D.C.
This certainly sounds like a rational approach that would, as Garen puts it, “reduce costs and assure that people use their insurance more responsibly.”
It certainly differs from Obamacare’s either/or mandates, which, according to a Families USA report, have resulted in one out of four people who purchase plans on state government-run exchanges skipping doctor’s appointments and important tests because they can’t afford to pay for them and their premiums.
Garen’s ideas pose cost-saving alternatives to Obamacare’s approach, which has resulted in subsidies of up to 400 percent being offered for families of four making more than $85,000 a year.
“That’s simply off the mark,” Garen said. “Do you think you’re really helping the poor and sick by handing out subsidies to people earning $85,000 a year?”
Kentucky’s uninsured poor and sick would be helped the most by replacing Obamacare and Kynect with a safety net consisting of high-risk pools or cash assistance that could be used by low-income individuals who can’t afford traditional plans but are Medicaid-ineligible to shop for and purchase their own policies.
“It would be similar to a food-stamp policy—only in this case it would be for health care and would give individuals control over the assistance in ways that best fit their personal situation,” Garen said. “They could, for example, use the assistance to purchase insurance plans with low deductibles if that works better for their personal financial situation.”
We could do worse than the nation’s governors—including Kentucky’s next chief executive who will be elected in November—telling Washington: “Take the billions of dollars landing in Obamacare’s bedpans, bundle it in block grants, give it to us in the states, allow us to deregulate our health-insurance markets and use the money to fund accounts for our neediest citizens.”
These are sensible alternatives that meet Obamacare’s stated objective: drive down costs, make health insurance affordable and provide a safety net.
In fact, the only either/or approach is the Obamacare one: Take it or take it.
Its mandates don’t even offer us the reasonable option of leaving it.