Republican presidential candidate Carly Fiorina, former chairman and CEO of Hewlett-Packard, has a plan if the U.S. were to do away with the Affordable Care Act.
Writing for TIME Magazine, Ms. Fiorina underscored the shortcomings of the healthcare reform law, including that enrollment is below original projections and premiums and deductibles are up.
Instead, here is what she laid out as her plan of action for healthcare.
1. First, Ms. Fiorina would repeal the ACA. Unsurprisingly, the Republican candidate's first step would be to do away with the healthcare law, which she also credits to crushing the small businesses of the U.S.
"Nowhere is the disregard for the laws of our nation — and the failure of our bloated, inept, partisan government — more obvious than in the way the Democrats foisted Obamacare on us," Ms. Fiorina wrote.
2. Much of what follows is based on a plan from U.S. Rep. Tom Price (R-Ga.). Rep. Price's plan, dubbed the "Empowering Patients First Act of 2015," a 242-page bill that includes details on tax credits for health insurance coverage, health savings accounts, limitations on abortion funding and limitations on employer-provided healthcare coverage, among other provisions.
3. Informed by this bill, Ms. Fiorina would protect Americans with pre-existing conditions in state-run high-risk pools. High-risk pools are similar to the ACA provision, the Pre-Existing Condition Insurance Plan, which is essentially a federal high-risk health insurance pool that was used before the exchanges were established and payers were not allowed to deny coverage based on health history.
Many states have offered subsidized coverage in high-risk pools, though premiums tend to be higher for individuals in these pools — even up to twice as much as those paid by healthy individuals, according to HealthCare.gov. The federal high-risk pool was also found to be unsustainable long-term. Ms. Fiorina does not detail how she plans to make the pools sustainable in her TIME essay, but she does say she would incentivize their creation with federal grants.
4. Ms. Fiorina calls for interstate purchase of health insurance. This is a policy that proponents say would increase competition among payers and subsequently lower prices. While some states have passed laws to allow out-of-state purchasing and the ACA allows interstate payer compacts, having a free market for health insurance across the country is untested. The National Association of Insurance Commissioners opposes the idea, stating it would reduce options available to consumers, reduce payer accountability and create a "race to the bottom."
5. Lastly, she called for greater transparency among healthcare providers. "Every healthcare provider ought to be publishing its costs, its prices, and its outcomes," she wrote, as this would allow patients to take more control over their own care.
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