As election coverage continues for the 2017 presidential race, we will certainly be hearing more regarding healthcare coverage. Hillary has made us all aware that she will continue to expand the current Obamacare coverage because she believes in the results. She believes the ACA law is directly responsible for 16 million additionally insured people, many of whom are young, have pre-existing conditions, and are women who were not receiving the coverage or care the deserved.
To achieve her goals, it requires more government influence to oversee processes in the health insurance industry and medical facilities in order to maintain compliance with the laws, greater stimulus for services to continue the growth of the Medicare Advantage and Medicaid programs, and a move toward centralization of services similar to a single-payer system.
- Clinton will continue to enforce the existing law requiring health insurers to disclose costs of medical services, claims payment processes, and quality data to consumers. She will block or modify health insurance rate increases if they are found to be unreasonable. Hillary talks about tax credits of up to $5,000 per family intended to offset some of the excessive out-of-pocket and premium costs if they go above 5% of their income. This is in addition to ensuring that families buying health care coverage on the exchange will not have to pay more than 8.5% of their household income for premiums.
- She extends these out-of-pocket costs and premium restrictions to include the family glitch created when employers’ coverage exceeds the cost of health care marketplace coverage. Further, she includes three sick visits a year without having to meet a deductible. She is very aware that deductibles have tripled in the last 10 years while copays have continued to rise and proposes to reduce these costs. Self-insured employers, including hospitals, will need to partner with national insurers to control the payroll contribution costs of insurance and work toward true cost reduction rather than simply shifting risk from employers over to consumers.
- Emergency services will not be subject to additional costs because they were not provided by a participating network provider. Fees to the hospital and physicians will be the same if it is a true emergency. High health care costs keep people out of the hospital when they really need help and that goes against the purpose of providing the coverage in the first place.
- Clinton wants to expand Obamacare and the incentives to states to expand Medicaid coverage. This includes adding a public option to choose between government offered and privately offered coverage, providing health care to all residents regardless of immigration status, and expanding the delivery system and technology for plans available through exchanges. Innovations in the delivery system can increase efficiency and maintain more accurate and accessible records. There will be rewards offered to insurers and providers contributing ideas for increased quality, consumer experience, and cost control.
- Hillary will improve the value of Medicare and Medicaid coverage by standardizing the evaluation and improvement process. This means insurers need to work with large regional providers and America’s Health Insurance Plans (AHIP) which is part of The Core Quality Measures Collaborative (CQMC), along with many national physician organizations to remove poor quality hospital and physician services from networks and produce information to positively affect each facility’s business practices, cost, and patient satisfaction.
These five areas listed encompass many parts of the existing healthcare system and ACA law. Hillary Clinton’s election coverage will also show concerns for defending women’s rights for access to full healthcare, greater initiatives in autism research, Veteran’s health care, children’s vaccines, and the need for more research into the use of medical marijuana. Many of her enterprises go beyond the United States to become global health concerns as well. Overall, she wants greater culpability and better availability of health care and services and lower costs without disrupting Obamacare’s momentum. There is a continual need for improvement and she is focused on the parts of the law that need revising and expanding but with the same goal in mind: universal affordable healthcare coverage for all US residents.
Resources and Links:
- Appold, K., 2016. Seven Ways Hillary Clinton Would Change Healthcare, http://managedhealthcareexecutive.modernmedicine.com/managed-healthcare-executive/news/seven-ways-hillary-clinton-would-change-healthcare?page=0,0
- Rappleye, E., 2015. 10 Things to Know About Hillary Clinton’s Views on Healthcare, http://www.beckershospitalreview.com/hospital-management-administration/things-to-know-about-hillary-clinton-s-views-on-healthcare.html
- Kodjak, A., 2016. Hillary Hitches Her Health Care Wagon to Obamacare, http://www.npr.org/sections/health-shots/2016/02/23/467736627/hillary-clinton-hitches-her-health-care-wagon-to-obamacare