Jeb Bush, who’s described Obamacare as a political “loser,” will unveil his plan Tuesday to replace the health insurance law with a system that he believes will cut back on regulation and lower health care costs.
The Republican presidential candidate said as recently as last week that he believes the law can be repealed, and he plans to lay out a proposal for undoing the law at the New Hampshire Institute of Politics at Saint Anselm College.
“I think Obamacare will collapse under its own weight,” he said in Oskaloosa, Iowa. “Politically, it doesn’t get better with time. It actually, I think, is likely to get worse.”
But, he has argued, Republicans need to offer a viable replacement.
For Bush, that means allowing state exchanges to continue to exist, if they so choose, but they would not be mandatory. He wants to enable access to affordable, catastrophic plans and provide a tax credit to purchase policies that protect Americans for costly medical events, according to his campaign.
Bush also wants to expand Health Savings Accounts, one of his elder brother’s pet programs. He would increase contribution limits and uses for these accounts, which must be paired with high-deductible health plans. Enrollees can use the funds in their accounts to pay for medical care.
“We’re going to call for moving to a system that is consumer driven with a lot more transparency,” he said in Iowa. “No employer mandate, no employee mandate, no mandated benefits.”
Bush doesn’t favor doing away with everything from the current law. He supports the continuous coverage guarantee provision for people with pre-existing conditions, and previously Bush has said he favors allowing kids to stay on their parents’ insurance plans until the age of 26.
To promote innovation, he also wants to reform the Food and Drug Administration’s regulatory policies and increase funding and accountability at the National Institutes of Health, according to the campaign.
And he’d like to see more leaders in the private sector figure out ways to enable better access to patient de-identified Medicare and Medicaid claims data.
Repealing Obamacare will not be a simple task. There are more than 10 million people enrolled in the federal and state Obamacare exchanges. Some 87% of them are receiving federal subsidies averaging $272 a month, to lower the cost of their premiums. And 56% of them receive separate subsidies to reduce their out-of-pocket expenses.
Also, Bush would jettison the expansion of Medicaid to all Americans under age 65, which 31 states and Washington have adopted. Nearly 13 million people have joined Medicaid since October 2013, when expanded enrollment began. Prior to Obamacare, it was difficult for adults, particularly childless adults, to sign up for the safety net program in many states.
But in an interview this weekend Bush described Medicaid and its expansion as “one of the worse insurance programs in the country.”
Bush’s plan also shifts away from Obamacare’s focus on preventative care. Under health reform, insurers must provide so-called essential health benefits, including mental health counseling, maternity coverage and emergency services. Also, enrollees in Obamacare plans can get an array of free annual screenings for conditions such as diabetes and high blood pressure and vaccines. Women can get an annual gynecological visit and mammograms.
Bush’s campaign says he would allow employers to use financial incentives to encourage wellness programs.