Could the federal government hasten a cure for Alzheimer’s disease by offering a $1 billion prize? That’s one of the new twists in the House Republican Study Committee’s plan to replace the Affordable Care Act.
Rep. Robert Pittenger, who represents North Carolina’s ninth district, pushed that plan when he was in Charlotte recently.
Most of the 2015 American Health Care Reform Act, introduced last week, is picked up from the version that debuted in 2013. The plan would repeal “Obamacare,” eliminating federal mandates that individuals must buy health insurance and that companies have to provide certain levels of coverage, including for people with pre-existing medical conditions.
The ACA provides tax credits, or subsidies, that go directly to insurance companies to reduce premiums for low- and moderate-income individuals. The House GOP plan offers a tax deduction of $7,500 for individuals and $20,500 for families who have health insurance. That approach includes people with higher incomes, while those who don’t earn enough to pay much in income tax wouldn’t find it as helpful.
The House GOP plan also allows insurance companies to sell across state lines, provides doctors more protection against malpractice suits and reauthorizes state high-risk pools. Pittenger said the key is using personal choice and market competition.
“What we want to do is drive the cost where it is affordable,” Pittenger said. “It gets away from government mandates.”
Conservative health writer Philip Klein, author of “Overcoming Obamacare,” says the credits vs. deductions debate “can quickly turn a meeting of normally mild-mannered conservative health policy wonks into a bloody scene from Game of Thrones.”
“A tax deduction merely reduces individuals’ tax liability. So, for instance, if somebody earning $50,000 receives a $10,000 deduction, that person only has to pay taxes on $40,000 worth of income,” Klein writes. “Creating a deduction for individuals to purchase insurance is a purer limited government approach, because it’s effectively just a tax cut.”
“The drawback of such an approach for those seeking to expand coverage is that it wouldn’t benefit individuals who owe little or no money in taxes against which to take advantage of the deduction, a population heavily represented among the uninsured,” Klein adds. “That’s why others on the right prefer handing individuals a tax credit to purchase coverage. If a tax credit is $2,000, for instance, and an individual doesn’t owe the government any taxes, that person would still receive $2,000 from the federal government.”
If the Supreme Court overturns the ACA subsidies in a ruling expected this month, that’s likely to energize Republicans’ perennial push to repeal the act entirely or at least scrap some of its key mandates.
Pittenger says he also hopes the latest plan will get some juice from the addition of a $15 billion, eight-year medical breakthrough fund to encourage research into heart disease, cancer, stroke, Alzheimer’s and diabetes. Included in that is the billion-dollar Alzheimer’s prize, pattered on the Xprize for innovative technology, a summary of the act says. The prize “will use free-market principles to spur private investment into finding a cure or vaccine for a disease that is projected to cost Medicare and Medicaid more than $500 billion per year within the next three decades.”