If ACA is Struck Down… What’s Next?

Any day now the Supreme Court will give its ruling on the  Constitutionality of the Affordable Care Act, a.k.a. Obamacare.   When the hearings were taking place, back in March, the media buzz did not spell a favorable outcome for the President and his healthcare law.  With signs pointing towards a 5-4 decision against the bill it only begs the question as to what’s next? Few believe that our healthcare system is perfect.  There are millions of uninsured people, costs are ever-increasing, and ideas to fix those problems are scarce at best.  Whether you like the President’s healthcare plan or not at least it was an attempt to fix those issues.  So again, if the bill is struck down – what’s next?

Assuming the ACA is deemed unconstitutional we’ll have to start over and figure out a solution to the two main problems: Americans without healthcare, and the skyrocketing costs of healthcare.  Here are some ideas.

First, there needs to be competition and transparency in the insurance market.  The current insurance market creates a system where insurance companies are rewarded for covering healthy people while denying insurance to the sick. How do we fix this problem? Get rid of denying healthcare due to pre-existing conditions. Which by the way is part of the ACA that is bipartisan supported. Then, set a minimum level of coverage that all insurance plans must provide.  This creates transparency in the system by guaranteeing some type of standard coverage on which all people can rely, and prevents insurance companies from charging high premiums for plans that cover little.  It also creates a competitive market where insurance companies will work to offer less expensive coverage in order to attain more customers. Just like the free market is supposed to work.

Second, programs already in place need to be more accessible to more people.  Allowing more people to enroll in Medicaid potentially drives down costs in the long-run and insures more people at the same time.  A recent study was done where researchers enrolled uninsured people into Medicaid and the result was substantially lower costs (almost half as expensive).   By giving people, who tend to use emergency rooms for their primary care, actual primary care, it dramatically reduced costs.  In doing so, no longer will minor illnesses or nagging injuries turn into much more serious and much more expensive emergency room visits.  This means more people being covered with fewer government dollars being spent.

Third, we have to keep Washington out of it. The inefficiencies of Washington are becoming more and more evident, and those inefficiencies cannot be carried into the healthcare market.  An independent board or committee, outside of Congress, needs to be implemented to control things like Medicare costs.  Too often is Congress paralyzed by the fear of voters and campaign contributors to even mention changing Medicare.  Well that needs to be changed.  This is why an independent board works well.  It’s main concern will be ensuring the solvency of Medicare and not catering to special interest groups.

Finally, we need to start paying doctors based on quality not quantity.  Our current system rewards doctors for performing unnecessary tests.  Rather than paying on a per procedure basis, we should be paying for treatment of the patient. In this system, doctors will be paid for treating someone’s illness as whole rather than all the individual tests.   This should work to reduce overall costs.

These are measures that should have bipartisan support. Republicans should like them because it lets the free market dictate costs and it lowers costs, which means lower deficits. Democrats should like them because they provide insurance to more Americans.

One last note: If you added an individual mandate to this list you would have the foundation for Obamacare. Sadly I didn’t come up with these ideas myself, no, these are all reforms created by the President’s healthcare law.  And as I said, most of these ideas should have bipartisan support. The problem; however, in the current political climate anything the President does is immediately wrong.  Even though much of the law is based on the Republican’s plan from the 90’s, the right now views it as a march towards a socialist takeover of healthcare.

The Affordable Care Act is not a perfect plan by any means, but it does have a lot of good ideas and possible solutions to the problem of healthcare.  Which arguably is the biggest problem the country faces.  It’s a shame Republicans have completely rejected it because it was implement by a President they don’t like.


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