04/14/2017

Give Medicaid Dollars Directly To Patients

Justin Haskins and Michael Hamilton, Wall Street Journal

As Republicans take another crack at devising a plan to replace ObamaCare, here’s an idea they should consider: Give each Medicaid patient a health savings account—and put $7,000 in it every year.

Under ObamaCare, Medicaid has become the only option for millions of Americans. But that doesn’t mean much if the doctors in their communities don’t accept new patients through the program—and 30% of physicians don’t.

The GOP’s recently benched health-care bill would have substantially reformed Medicaid by giving the states block grants, along with more flexibility on how to spend the money. But there’s a better model. Republicans should empower Medicaid patients by providing funds to them directly, which would allow them to build a personal safety net that could last a lifetime.

Washington and state governments spent $545 billion in 2015 on 73 million Americans covered by Medicaid and the Children’s Health Insurance Program. Instead lawmakers could take $511 billion of that total, divide it equally among enrollees, and give each one a health savings account with $7,000 a year. This would be real money for the poor, stored in real private accounts.

Recipients could use the deposit to buy health insurance and cover the cost of prescriptions, copays, deductibles and other related expenses. Unspent money would carry over to the following year. Enrollees could share that $7,000 with a sick spouse, sibling, parent or child.

Most recipients would probably use the funds to buy private health insurance, many for the first time. The average annual premium last year for an (overpriced) bronze plan on the ObamaCare exchanges was about $3,100 for a 30-year-old, $3,500 for a 40-year-old, $4,900 for a 50-year-old, and $7,400 for a 60-year-old. After that, at age 65, Americans qualify for Medicare.

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