New Approach Needed To Address National Health Care Crisis, Opinion Piece States
Competing strategies to address a "lack of adequate health insurance among growing numbers of Americans" and an "unsustainabl[e]" rise in health care costs have resulted in a "political standoff that has blocked an honest evaluation of any major approach and has left everyone frustrated," Henry Aaron, a Brookings Institution senior fellow in economic studies, and Stuart Butler, vice president for domestic policy studies at the Heritage Foundation, write in a Washington Post opinion piece. To address these "twin adversaries," Aaron and Butler assert that Congress should allow individual states to pursue various strategies on their own and should reward successful programs with "grants sized according to their progress toward agreed targets." The authors propose the following four steps to achieve their plan:
- Congress would set goals for states that would include reducing the number of uninsured people. However, Congress would not necessarily set a national base coverage level to classify a person as insured. Congress also would encourage states to find ways to improve care delivery services.
- Congress would pass a "federal policy toolbox" of strategies from which states could select policy options. The toolbox would include tax credits for individuals or businesses to purchase coverage, expansions of Medicaid or other programs, plans targeted at children and the near-elderly, association health plans or the extension of the Federal Employees Health Benefits Program to nonfederal employees.
- States could choose freely among the previous options and, within the minimum federal standards, adopt their own strategies, including single-payer health systems, which would allow that policy to be tested on a "limited scale."
- Congress would commit to providing grants, in addition to current federal funding to each participating state, based on progress toward the agreed goals. However, for "both political and policy reasons," Aaron and Butler write that the federal government "should sustain the Medicaid entitlement, financed by an uncapped federal matching grant." Congress also would fund studies of the plans' progress.