Clinton Shares Health Care Reform Plan To Lower Out-of-Pocket Costs
The new proposal comes after Clinton earlier this week unveiled a plan aimed at curbing the costs of prescription drugs.
Plan Focuses on Limiting Consumers' Out-of-Pocket Health Care Costs
Clinton proposed requiring insurers to provide coverage for three sick visits to a physician annually that would not count towards a consumer's deductible (Becker, Reuters, 9/23). In addition, she noted that under her plan, consumers would "pay no more than in-network cost-sharing" if they receive care at an in-network hospital or if they are receiving emergency services in the instance of "a true emergency" (Clinton fact sheet, 9/23).
Further, Clinton's proposal calls for the creation of a refundable tax credit of up to $2,500 for individuals or up to $5,000 for families to combat out-of-pocket expenses. The credit would be available to insured U.S. residents who have out-of-pocket costs exceeding 5% of their incomes "and who are not eligible for Medicare or claiming existing deductions for medical costs" (Gearan, "Post Politics," Washington Post, 9/23). Clinton noted the tax credit would be fully funded through rebates from drugmakers and increased payments by higher-income earners (Radnofsky, Wall Street Journal, 9/23).
Clinton also said she would enforce rules under the Affordable Care Act and take further steps to increase the transparency of health plans' out-of-pocket costs, physician networks and prescription drug costs (Clinton fact sheet, 9/23).
The proposal also includes provisions to combat "unreasonable" premium increases by creating a fallback option for states that do not currently have the authority to block or alter premium hikes in their state (Reuters, 9/23).
Clinton cited an increase in health care mergers -- "both on the provider side and on the insurer side" -- and said she would "vigorously enforce antitrust laws to scrutinize mergers and ensure they do not harm consumers.
The proposal also includes provisions that would leverage public and private resources to promote entrepreneurship that improves U.S. residents' health and financial security.
Promoting Value-Based Care
Clinton noted that reducing costs and improving quality will necessitate a continued shift away from the current fee-for-service payment system. In her proposals, Clinton called for implementing new value-based systems and expanding alternative payment models, including bundled payments and accountable care organizations. Clinton also said she would promote public and private efforts to encourage insurers and employers to expand on successful delivery system reforms.
Meanwhile, Clinton's campaign said she will propose more health care reform initiatives, such as releasing the full details of her delivery system reform plans "in the coming months" (Clinton fact sheet, 9/23).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.