Dear 45 Health Care
Mar 23, 2016 - 9:00am

Dear 45: America’s Health Care System Needs Mending

Dear 45,

Six years ago today, your predecessor signed the most significant piece of health care legislation in decades. Obamacare, as the law became known, has radically changed the structure of our country’s health care system, and it will continue to define President Barack Obama’s legacy long after his presidency. How your administration handles the law’s remaining implementation and how you approach health care policy more broadly will have similarly lasting implications for your legacy and – more importantly – for our country.

First, it’s important for you to acknowledge that while the Affordable Care Act is far from perfect, it’s the law of the land. It’s up to your administration to focus not on repeal, but on targeted, strategic changes that will make the law and our health care system more workable for all Americans.

That should start with fully and permanently eliminating provisions like the Cadillac Tax, which will lead to higher costs and less robust coverage options for employees. While businesses caught a break when the Cadillac Tax was delayed late last year, only the tax’s permanent repeal can mend problems that are already driving companies to modify and scale back health care coverage options.

Similarly, the next administration should repeal provisions such as the health insurance tax and the medical device tax. Both will result in additional cost increases passed on to employers, which will further drive up costs for their employees. Same goes for Obamacare’s ban on stand-alone Health Reimbursement Arrangements (HRAs), which limits access to care for many employees. With these commonsense changes, we can remove some of the barriers that are obstructing access to affordable and high-quality health care for millions of American workers.


As president, we also hope you help renew our country’s focus on workplace wellness. Health care can't begin and end with treating those who have fallen ill or injured; we have to think about ways to more effectively keep Americans healthy. We hope you will structure rules and regulations in such a way that support workplace wellness and chronic disease management programs, which have been shown to help control costs and improve health.

Which brings us to a broader point, one that we believe must be at the heart of your health care policies: prioritizing and protecting the employer-sponsored health care system. It is the bedrock of our country’s insurance system, and it’s a system that works best when we err on the side of flexibility for employers rather than piling on onerous, heavy-handed rules and restrictions. Ideally, Obamacare (and more broadly our entire health care system) should encourage employers’ innovations, as well as their commitments to providing high-value coverage. This will lead to higher quality and more accessible and more affordable health care options.

Our country’s health care system remains the envy of many around the world, but in order to ensure that it stays that way, you and your administration must double down on the elements of the system that have worked so well for decades while mending those provisions of the Affordable Care Act that threaten to restrict access to quality care. In this and all other challenges, we hope that you will work closely with the private sector to find solutions that help improve the lives of all Americans.


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