What Do Americans Think Is Broken In Health Care? What Trump And Biden Would Do About It

Our broken health care system has been a campaign talking point for generations, and 2020 is no exception. But what do people think is broken? What does your average worker, parent, student, or small business owner want fixed? My organization, the Foundation for Government Accountability wanted to know the answer to these questions.

When you ask more than 10,000 Americans in focus groups and polling what they want fixed in health care, you get some interesting and unexpected answers. The answers varied, but two themes were overwhelmingly represented: Health care remains top of mind for many Americans and they want more affordable coverage options.

President Trump’s Actions On Health Care

To his credit, President Trump has focused on how to address these concerns despite the Senate’s failure to pass health care reform early in his term. Without legislation to make broader health care changes Americans need, the administration used several tools in its executive authority toolkit to make progress on more flexible short-term health plans and association health plans (AHPs). The administration and Congress were also able to work together to remove the ObamaCare individual mandate and combat the opioid epidemic.

These changes aren’t just bullet points on a list of accomplishments. They have real-life implications for millions of Americans.

Short-Term Plans Can Help Americans In Transition

For a hardworking mother going through a divorce, a short-term plan gives peace of mind. It means she can cover her family during that transition rather than go uninsured. And for many more everyday Americans, short-term plans offer the most affordable path to coverage in an expensive individual market.

Short-term plans are not for everyone and are not the solution to every problem in health care. But they are a solution to one of the biggest problem a 27-year-old faces in a job without benefits and the biggest problem for 63- or 64-year-old Americans looking for an insurance bridge to Medicare.

The question isn’t whether they’re right for everyone. The question is who they are right for. And the vast majority of those that have signed up for short-term plans were previously uninsured. Why? Because the premiums for short-term plans are, on average, 59 percent less expensive, with eight times more plans available.

Like short-term plans, the administration’s efforts to open up more association health plans has received inadequate attention.

Association Health Plans Can Help Your Local Small Businesses

Think of the staff at your favorite local restaurant. The owners want to take care of their employees but, at least historically, it has been too expensive for them to offer their employees health coverage and stay in business. For years, big businesses have had advantages when buying health coverage, but small businesses and their workers were left scrambling in a different, more expensive market.

With association health plans, the administration’s new rules are finally helping the small guys.

AHPs allow main street small businesses to pool together to purchase health coverage previously reserved for bigger businesses. The result is simple: better insurance for less money.

And it’s not just about health care, either. With an AHP, your favorite restaurant can hire more workers, offer more benefits, or give raises to current employees. For employers like a caterer in Florida, AHPs gave her an off-ramp from plans with premiums that were increasing by double digits most years. Now, her business has coverage that is 25 percent lower. For 43,000 farmers in the Midwest working with Land O’ Lakes, AHPs mean savings of 25-35 percent. That’s better coverage but also thousands more dollars in the pockets of farmers for groceries, mortgage payments, or equipment repairs and supplies.

Biden’s Plans Appear Focused On More Government

Vice President Biden has been talking about new options, as well, but they include either more government money or a government-run program. He wants to move individuals into Medicare under a “public option.” This so-called solution simply pits these new enrollees against older adults on the program in a competition for limited resources. The Medicare program is on shaky ground already.

He also wants to increase subsidies to insurance companies, and uncap the income limit on who can get these taxpayer-funded subsidies. These subsides only mask the underlying issue of increasing insurance premiums and are limited to plans on exchanges operated under ObamaCare rather than focusing on offering patients more creative, private solutions.

And he wants more able-bodied adults on Medicaid, despite its bursting state budgets, and using up resources that were intended for care for those originally on the program such as low-income children, those with disabilities, and seniors, many of whom sit on wait lists for community-based services.

These ideas are not new, and that is the problem. Doubling-down on some of most broken pillars of the current health care system does not help patients in the long run.

Americans Want to Fix What Is Broken In Health Care

Americans want more affordable health coverage options, not more of the same. We need reforms that give patients options that are sustainable, affordable, and reflect the many different life stages that Americans find themselves in.

With short-term plans, AHPs, and other reforms, the president’s administration has gotten one big thing right in our efforts to fix a broken health care system—increasing individual options instead of building more one-size-fits-all bureaucracies that know nothing about the health needs of your family.

Continue the conversation on Twitter: @josharchambault

A version of this piece first appeared here.