At a free forum event at The Heartland Institute headquarters on Wednesday June 7, Charlie Katebi – a fellow in health care reform at the Millennial Policy Center at the Liberty Group in Denver – spoke on the topic of “A Health Care Agenda for Millennials.” Katebi, who also writes for the Federalist, explained how America’s health care system is rigged against Millennials.
Under the Affordable Care Act (Obamacare), young people face higher costs, fewer choices, and less access than ever before, even though they can stay on their parents’ insurance until age 26. This is the result of increased government interference in our health care system.
It is worth noting that prior to introducing Katebi, Heartland’s Government Relations Director John Nothdurft prefaced the event by pointing out how important it is for Heartland to maintain a team dedicated to delivering free-market solutions to lawmakers all over the country.
Charlie Katebi speaks
In speaking about the difficulty of repealing Obamacare, despite it collapsing under its own weight, Charlie Katebi took aim at powerful groups that come out to tell how untold hardship and suffering will occur should Obamacare be repealed. Notable is that these comments are not coming from groups consisting of young people. As such the group Katebi represents (Liberty Group) is trying to give young people a larger voice in the discussion.
About premiums for young people: They are high under Obamacare, because they must cover the cost of older people who are likely to have a number of costly medical problems. These inflated costs discourages young people from buying insurance. Only 1/3 of adults under 30 are insured, and only 2% of millenniums are starting businesses, because they don’t have the money to do so.
Obamacare isn’t the only reason why healthcare is so expensive. According to Katebi, a barrier to healthcare reform is employer provided insurance. 160 million rely on their place of work for health insurance. Benefits are excluded from taxation, making employer provided insurance the 2nd largest entitlement besides Medicare. Often companies offer only one healthcare plan, and many times they pay 80% of the premium.
As noted in a Health Affairs article titled, “Employment-Based Health Insurance: Past, Present, and Future”:
Most employers offer a single carrier; their insurance companies give them incentives to do so or even require it. Because, understandably, people want to be able to choose their doctors, delivery systems that limit patients’ choice of doctor are not suitable candidates for the single-carrier role. Many employers who do offer such alternatives contribute much more (like 80–100 percent of the difference) on behalf of the more costly, usually FFS, alternatives. When employers do this, they do not provide an incentive for employees to choose the economical alternative, and it is not possible for the efficient systems to gain market share by superior efficiency. Employers are reluctant to expose employees to full cost differences in tiered networks. In other words, despite appearances, in most of the employer insurance market, competition over value for money is ruled out.
A somewhat heated argument arose over the discussion of employer-related healthcare by a firm supporter of it, who suggested that employer-related healthcare encouraged employees to stay loyal to a company which then resulted in less turnover. Not so said Katebi. It caused job lock, as it tied people to their work and therefore discouraged people from moving to other jobs offering higher wages. Katebi suggested that a cap be placed on employee-based healthcare, or that this practice be ended entirely. Instead, Katebi said, employees should be offered a tax credit and a health savings account.
Allowing a person to remain in an insurance plan despite a debilitating illness raises insurance costs for everyone. A separate, high risk market pool for these people would help lower insurance costs. For if young people don’t buy health insurance because it is too expensive, no health care reform plan will succeed. Most importantly, individuals should be able to purchase a healthcare plan in accordance to their need (individualize), with exclusion as a necessary option. Men should not be paying for healthcare that only women need and women for problems encountered only by men. Katebi cited that Obamacare has 78 mandates.
What the new GOP healthcare bill means for employers?
The House of Representatives passed the American Health Care Act Thursday, May 4, 2017, which was then sent to the U.S. Senate for debate, amendments, and then a vote.
- It gets rid of the employer mandate. The American Health Care Act (AHCA) eliminates the controversial requirement under the ACA that employers provide health insurance to employees. However, this is unlikely to have a significant impact on most organizations, which will continue to offer health benefits to attract and retain top talent.
- It pushes back implementation of the Cadillac tax.
- It gives states greater control over what’s included in health plans.
- It gives states la say in pre-existing-conditions cover.
- It opens up HSA’s by repealing taxes on health savings accounts. Under the House’s GOP plan, individuals can put $6,550, up from $3,400, and families can put $13,100, up from $6,550, into a tax-free HSA.
Senate version of AHCA still uncertain
Senate Republicans are now struggling for consensus as they seek to keep the party’s campaign promise to repeal and replace the ACA, in an atmosphere where there is no Democratic support for the Republican bill.
One of the few components of Obamacare that received bipartisan backing and broad support was protection for those with pre-existing condition
In an article published on June 8, 2017, Senator John Cornyn of Texas, the No. 2 Republican leader, told news reporters when addressing the needs of people who already have serious or chronic health conditions, that this is a key priority in negotiations for a Senate bill, although the specific approach has not yet been finalized. Senate Leader Mitch McConnell likewise backs ACA pre-existing illness policy.
Addressing the needs of those with pre-existing conditions could help McConnell attract votes of moderate Republicans including Bill Cassidy of Louisiana, Lisa Murkowski of Alaska and Susan Collins of Maine.
A measure that could prove positive to lowering insurance premiums is now under discussion. Senator John Hoeven of North Dakota is helping to draft a measure to create a federal reinsurance pool for people with chronic illnesses, so they won’t be worried about losing affordable coverage because of a pre-existing condition. At the same time, a Reinsurance Pool would help lower premiums for those who remain in the regular insurance market.
Salient points by Charlie Katebi
For health insurance to work, it must be perceived that everyone is getting a fair deal and that young people don’t have to pay too much for their health insurance.
Health care is expensive. Someone must pay for it, but no one can define what a person’s fair share should be.
When asked by young people whether healthcare is a right, Katebi tells them that your right doesn’t matter as long as those who need healthcare get it.
When a Heartland guest made the observation that all roads in the healthcare debate seem to lead to a Single Payer System, Katebi gave this grim outlook: If a Single Payer System ever came to fruition, Death Panels would be a necessary component of it.
[Originally Published at Illinois Review]