1115 Medicaid Transformation Waiver. Support an extension of the 1115 Medicaid Transformation Waiver and a call for negotiations with CMS to develop an appropriate renewal of the waiver at the end of the extension period.
Access and quality. Support increasing access and choice of health care programs by promoting the need for market-driven health care policies. TAB would support a proposition that would provide for the equal tax treatment of individual and group health insurance. Further, TAB encourages growth and reform in the individual marketplace.
Bipartisan Medicare Secondary Payer and Workers’ Compensation Settlement Agreement Act. Support efforts to streamline the settlement process by providing consistent standards and reasonable protections for injured workers and Medicare. Creating certainty will save millions of dollars in unnecessary administrative costs
Chronic disease management. Effective disease management enables patients to live with their disease, getting on with their lives without being incapacitated. TAB supports legislation that would create better, more efficient tools for implementing good disease management programs, such as telemedicine, especially in the commercial insurance market. TAB would also support programs that help to facilitate changes in patient behavior.
Drug reimportation. Support efforts for Congress to study drug reimportation as a way to contain costs while also ensuring patient safety.
Effective competition in health care markets. TAB favors maximum reliance on market forces in the health care sector. In order for market forces to control costs and improve quality, there must be competitive markets. Health care providers and health plans have been consolidating since passage of PPACA. Consolidation can have benefits for consumers, but consolidation can also weaken competitive market forces to the detriment of consumers. Federal agencies should carefully monitor market conditions and apply current law to protect purchasers of health care services.
Employee Retirement Income Security Act (ERISA). Support efforts to preserve employer rights and employee health care system benefits of the ERISA. Oppose any legislation that would jeopardize the benefits of millions of Americans who receive their existing health insurance coverage through the employment-based system. Ensure that employers retain the right to craft their health care coverage without the burden of federal and state regulations.
Employer liability. Prevent needless increases in cost and litigation by way of the expansion of employer liability by opposing any legislation that creates or expands causes of action against employers and insurance carriers for medical negligence or harm incurred by health care providers. Support providing independent, third-party reviews of medical claims denials.
Health care costs. The United States is spending over 17% of GDP on health care while European countries with comparable populations are able to produce equal or better population health for 8-9% of GDP. The excessive U.S. public and private health care costs are preventing wage increases for workers, increasing federal debt and making public funds unavailable for other critical uses such as infrastructure, defense, and education. The federal government should identify the reasons for the high cost and low efficiency of the U.S. health care sector and determine what, if any, federal actions can reduce the percentage of GDP spent on health care.
Health care liability. TAB supports legislation to curb the use and abuse of class action lawsuits because it is critical to controlling costs in the health care system. These reforms are critical to controlling costs in the health care system, especially with the growing trend of courts extending theories of liability. TAB believes that it is necessary to increase the momentum to fight for better tort reforms in the realm of health care, including caps on medical malpractice for doctors and more succinct tort reforms overall.
Health literacy. Support legislation that ensures health literacy attributes are integrated throughout the taxpayer-funded health care enterprise system. Support the provision of plain language usage and disclosure of basic health information, including prices and quality of care, whenever possible to expand the capacity of individuals to make appropriate health decisions on an on-going basis. Support the development of a “Health Literacy” curriculum that is a required course study for all health care professionals so they may help educate Americans on proper self-care, appropriate services and unwarranted spending on unnecessary or duplicative services.
Health Savings Accounts (HSAs). TAB supports empowering individuals to better handle their share of health care costs and improve access to coverage through the expansion of HSAs and eliminating market restrictions on the accounts. TAB would support legislation to allow individuals to deposit pre-tax dollars to health savings accounts for individual or group policies and also would support increases and improvements in the variety of accounts that can be offered, as well as the carryover provisions.
Information Technology (IT). TAB supports the implementation of health IT initiatives to reduce medical costs and enhance care in rural, isolated and underserved communities. Easier access to personal medical records and treatment options allows patients to interact with physicians before health issues become more serious and more expensive to treat.
Mandated benefits. TAB supports eliminating federal and state mandated benefits, including those services required to be included in standard plans under PPACA. Further, TAB opposes any efforts to mandate specific benefits in health care coverage that significantly increase costs to employers and employees and eliminate the ability of employers and employees to choose the level of benefits they elect to pay for.
Market flexibility. Ensure that market-based solutions and approaches are used in our health care system. TAB supports making coverage more affordable by monitoring and opposing health insurance regulations that increase the costs and undermine the concept of a free market for contractual medical services without contributing to better access and better quality of care for patients.
Medical information. Support improvements in the quality of care and consumer comparisons by managing medical information and profiles of providers for health care purchasers and their employees, including the collection and sharing of cost and quality data. Monitor the Health Insurance Portability and Accountability Act (HIPAA) implementation and activities to ensure patient privacy and to protect the proper use of medical information and technology.
Medicaid reform. Support cost-containment in Medicaid. TAB supports converting the federal share of Medicaid spending into block grants, as a one-size-fits-all approach to addressing different states’ health care issues is not a workable solution. Block grants will allow for better use of limited dollars and will be more effective and better suited to states’ needs. Also, allow states to use Medicaid dollars for a means-tested, premium subsidy program for purchase of private insurance policies.
Medicare reform. Support cost-containment in Medicare. TAB supports changing specific components of the Medicare System by fixing structural problems that will allow the program to continue. TAB believes that making gradual structural improvements to Medicare will help to ensure that current enrollees continue to receive access to health care while also ensuring that the program will continue for future generations.
TAB also supports other changes to Medicare, including:
- Support continuation of Medicare Advantage and other private, free-market Medicare solutions that emphasize preventative care and wellness program;
- Change Medicare to a means-tested premium subsidy program for purchase of private insurance for people under 55. For those over 55, make this an option; and
- Remove the barriers to telemedicine in Medicare and expand the scope to include primary care. Also, remove geographic restrictions and site restrictions and allow telemedicine to be used for simple, non-emergent care in a way that maintains the dignity and independence of our senior citizens.
Out-of-network costs and balance billing. Address out-of-network charges and the barriers to affordability, including the excessive prices charged for medical services. These measures can include:
- Providing consumers with clear, easy-to-access information on in-network providers and cost estimates through provider network directories and cost calculators;
- Promoting greater transparency from providers and specialists regarding their network status, including disclosure from out-of-network providers regarding their fees and costs;
- Strengthening financial protection for consumers by imposing limits on balance billing from out-of-network providers; and
- Advancing state laws to protect consumers from surprise out-of-network charges.
Prescription drug coverage. Support the standards already set in place for electronic prescriptions. TAB opposes plans that give too much power to government bureaucrats. Business should promote plans that include private-sector benefit plans for prescription drug coverage and oppose plans that jeopardize the financial health of Medicare or try to increase payroll taxes.
Patient safety. Ensure patient safety and control costs by reducing the number of medical errors. Promote affordable, quality and safe health care.
Prescription drug monitoring. Support a federal prescription drug monitoring database that states can access and more easily identify doctor shoppers and drug seekers.
Reauthorization of the Prescription Drug User Fee Act (PDUFA). Support legislation allowing for the reauthorization of PDFU in order to ensure that patients’ access to life-saving and life-enhancing new medicines is not delayed. PDUFA creates a regulatory environment that is predictable, transparent and implements accountability for the Federal Drug Administration (FDA). This stability allows the businesses in the industry to deliver safe and innovative cures and treatments that will help people live longer, healthier and more productive lives.
Repeal and replace the Patient Protection and Affordable Care Act (PPACA) and the Health Care & Education Reconciliation Act. TAB supports the full repeal and replacement of PPACA (“Obamacare”). The law does little to stem the skyrocketing cost of health care and will be financed on the backs of small businesses. TAB supports legislation that will increase, not reduce, the quality of care for patients. Part of the package to replace PPACA should include the removal of mandated benefits, an increase in the use of tax credits and an increase in the flexibility of Health Savings Accounts.
Further, TAB supports the following initiatives as they relate to PPACA and beyond:
- Repeal of the Independent Payment Advisory Board (IPAB). PPACA created a new federal panel, which is comprised of unelected bureaucrats with unchecked authority to cut Medicare spending. IPAB’s recommendations are exempted from both judicial and administrative review and are fast-tracked through Congress, putting at risk patient access and medical innovation.
- Interstate insurance. Support the interstate marketing of individual health plans and allow insurance to be purchased across state lines. Support efforts to allow citizens to purchase insurance policies, which have been approved by the insurance boards of any state and contain adequate consumer disclosure, without imposition of individual, state insurance mandates, therefore increasing options for citizens in purchasing health care policies.
- Repeal of the Excise Tax (aka Cadillac tax). Beginning in 2018, a 40% tax will be applied to the value of employer-sponsored health care plans that exceed a threshold of $10,200 for individuals and $27,500 for families. One third of U.S employers are at risk for paying the tax if they do not adjust their current benefits. This tax is not indexed to inflation and will capture an increasing percentage of employers. It should be repealed.
Resident Physician Shortage Act. Support legislation that seeks to address the shortage of physician residencies in the United States. However, TAB believes that it is imperative that the allocation of federal dollars for physician residencies be based upon population and not on the historical location of residency slots.
Safe medicines. Support legislation that seeks to end the use of counterfeit drugs, which are a serious patient safety problem and a cost driver to employers.
Self-Referral. Remove all safe harbors for self-referrals to in-office ancillary services and physician owned hospitals. Support amending title XVIII of the Social Security Act to exclude certain advanced diagnostic imaging services from the in-office ancillary services exception to the prohibition on physician self-referral. The amendment would close an in-office “loophole” to the self-referral law that would exclude advanced imaging, including MRI, CT and PET scans. TAB supports this additional regulation because it will yield a very high return on the cost of regulation measured in improved quality of patient care.
Specialty prescription trend. Study the impact of specialty medicines on health care costs over time. Examine solutions to lower overall health care costs that balance the value of medical innovation with the necessity to manage costs.
Stop loss insurance. Support legislation that would preclude harmful regulatory action that could limit access to stop-loss coverage, ensuring that groups seeking to self-insure are able to access the necessary tools to do so.
Tax credits. TAB supports replacing the tax deduction and premium subsidies under PPACA for health insurance with a refundable tax credit. This means employees would pay tax on the amount the employer paid for employer provided insurance. TAB also supports developing alternatives for individually owned health coverage such as allowing above-the-line deductions for individuals who pay their own health insurance premiums (including premiums for long-term care insurance). Congress should create forward-funded, refundable tax credits for the purchase of private health coverage for low-income individuals and families and accelerate the 100% deduction of health insurance for the self-employed.
Transparency. Support legislation ensuring access to health care cost transparency for consumers. Also, support finding ways to make private health care coverage more affordable and to provide fair and adequate reimbursements for care because the absence of real prices creates perverse incentives on both sides of the market and needs to be fixed.
Wellness programs. Wellness programs in the workplace play a critical role in improving the nation’s health and productivity and should not be restricted. The programs are a win-win for both the employer and employees; employees are fitter, more productive, have better morale and are safer, and employers achieve excellent returns on their investment.