The plan I’m endorsing includes an innovative $100 billion grant program that incentivizes our “laboratories of democracy”—the states—to come up with insurance reforms and other solutions that can stem the rising tide of health costs. States’ eligibility for the grants would be tied to their ability to lower insurance premiums for their citizens.So we've got Free Money To The States, since everyone knows deep-red states have been doing a bang-up job of protecting their citizens' health over these last decades, and "lawsuit" reform, and—ugh, Health Savings Accounts. As someone who once had one, let me just note here that Health Savings Accounts need to die in a fire. For those of you with no experience in that particular clusterfudge of conservative financial sector skim-enabling hoo-ha, think of it as the equivalent of privatizing Social Security, except Social Security is now your gall bladder. And whatever else you've got.
We include other reforms in our plan too -- tax equity between employer and individually-purchased health plans, lawsuit reform, wellness incentives, and new incentives for Health Savings Accounts.
These reforms have proven track records of success -- and analysis from top economists to back them up.Except they don't, because in the long history of the before-times before Obamacare Republicans were perfectly free to do all of those things and yet the problem of accessible and even marginally affordable health care managed to spiral to crisis levels regardless. This is (1) because conservatives have fought every effort at reforming health care in the modern era, proposing "reform" after "reform" only in opposition to concrete reforms proposed by the other side, then dropping them again when the threat of true reform has passed, and (2) because several of the token efforts that have been tried or that conservatives have been most obsessed with—for example "lawsuit" reform—have not and will never make more than a token dent in the overall problem of access and affordability. Ever.
Our plan’s state grant program requires states applying for grants to guarantee access for individuals with pre-existing conditions. A state could guarantee access through a high-risk pool, through reinsurance, or through some other mechanism. But our plan ensures that the most vulnerable won’t fall through the cracks, and provides $100 billion in resources that states can use to subsidize that coverage.And yet when the federal government proposed near full federal subsidization of poorer and higher-risk state residents, i.e. the Medicaid expansion, conservative states engaged in competition to see which of them could most belligerently fend off the Free Money and keep those same citizens uninsured. The reason given was that the Free Money might turn into slightly less Free Money in the future, and also a member of the opposing party might get credit for the thing, so the conservative states decided eff the sick people—we can't take that chance. Truly, a movement dedicated to advancing citizen health and welfare. (All you need to do is look at state-by-state statistics to see which states have been doing a really ripping job of advancing health care for our citizens, and you would do Louisiana Gov. Bobby Jindal a very solid favor if you did not point out where Bobby Jindal's Louisiana is on that list.)
Honestly, this gets tiring. Yes, Mr. Bobby Jindal, thank you for your non-contribution to the debate, which was the same as all the other non-contributions offered up by equally insincere people who have promised that they'll get right on that whole health reform problem, for reals this time—but only if we dismantle every one of the reforms we've already put in place. We will put your little proposal on the pile, Bobby, and you get a Still Marginally Relevant lollipop. Lick sparingly, though, because that thing's gonna have to last a while.