Weekly Column of U.S. Senator Lamar Alexander (R-Tenn.) - The Right Framework for Health Care Reform

Posted on August 9, 2009

Last week, I, along with 11 of my Senate colleagues—seven Democrats and five Republicans—wrote an op-ed in the Washington Post about the Healthy Americans Act. The bill is sponsored by Senator Wyden, a Democrat, and Senator Bennett, a Republican, and I’m a cosponsor as well. There are a number of things I agree with in the bill and some things with which I don't agree. What I can say is, it’s a good start—it has the right framework upon which we can build a bipartisan discussion. I endorse the plan because the nonpartisan Congressional Budget Office has said it wouldn’t add a penny to the deficit, and because it wouldn’t create a government-run plan to compete with private insurance plans. People would have choices among private plans just like most people have today. It would replace Medicaid and the Children's Health Insurance Program with private insurance plans for most of those current beneficiaries. It wouldn’t replace all of Medicaid (which is called TennCare in Tennessee), but about 40 million of the people who are on Medicaid today, which is the largest government-run program we have, would have a choice to buy plans like the rest of us. One of the worst things about the Kennedy bill and the House Democrats’ version of the health care bill we are seeing is that they dump low-income Americans into Medicaid – a government-run program that is failing. The bipartisan proposal I support takes away that problem. The Healthy Americans Act instead would make a fairer distribution of the government subsidies we already spend to subsidize health care and let more Americans benefit from that. The Wyden-Bennett bill would give more Americans a chance to purchase the same kind of health-insurance policy federal employees and Congressmen have. It provides a tax deduction for all American individuals and families to address the unfairness of our tax system. It does include an individual requirement to purchase health insurance, but I believe that’s important. It means, in other words, no free ride, because we are all in this together. And states that implement some sort of reforms against junk lawsuits against doctors, which drive up the cost of their malpractice insurance and the cost of health care generally, will receive bonus payments. It also includes some important insurance market reforms. These insurance reforms would mean you have a right to purchase insurance without a physical examination, and if you have a preexisting problem when you go in to get health insurance, you cannot be denied for that reason. These are insurance reforms that are included already in virtually all the plans I have seen, both Democrat and Republican. And finally, the Healthy Americans Act provides a full subsidy to people living under 100 percent of the federal poverty level to buy a health plan, which is about $22,000 a year for a family of four. Americans earning between roughly $22,000 to $84,000 per year for a family of four will receive subsidies on a sliding scale. After that, you pay for it yourself. But again, this bill isn’t perfect. There are some points I don't like about the bill, but I endorse the framework. I hope that when Congress returns from its August recess we can start over on health care and make sure we get it right. The Wyden-Bennett bill is the best way to get reform moving in the right direction.