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Sotu Health-Care Plans


The administration’s talking points on health-care proposals are about what health policy nerds would expect: a mixed bag– with two surprises. The bright spots are proposals to expand health savings accounts (HSAs) and to allow individuals and employers to purchase coverage they want from any state they want. (This is where one of the surprises can be found; more on HSAs later.) Unfortunately, the president is still set on expanding federal power over the health care sector. His support for federally regulated “association health plans” and federal malpractice liability rules would shift state responsibilities to DC. (Can you have a more blantant violation of federalist principles?) Meanwhile, he would increase federal spending on: “health information technologies” (e.g., electronic medical records); “refundable tax credits” for health insurance (i.e., means-tested health insurance vouchers that increase marginal tax rates on those with low incomes); federal grants to states cover the chronically ill; and increased federal funding of community-health centers (central planning, anyone?). The second surprise? Rather than call for federal spending or federal mandates to force price transparency in health care, the president merely “urges” providers to post user-friendly price & quality info. Seems odd to praise a president for not proposing something stupid and unconstitutional. But if we don’t praise it, we’ll never see it again.


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