As part of our Solutions Series, the Wisconsin Institute for Law & Liberty (WILL) issued a policy brief Monday that proposes seven healthcare solutions, many with bipartisan support, that aim to lower the cost of healthcare and increase access. Despite differences over the role of government in health insurance coverage, policymakers can find common ground and work within the framework of the Affordable Care Act to address some concerns about increasing costs and the ability to access care.
Below, we provide a brief summary of each of these policies. More details can be found in the brief.
- Direct Primary Care – Direct primary care (DPC) offers one of the best avenues to cut out the costly insurance middlemen and allow patients and doctors to decide on care through transparent, up-front prices. In this system, clients pay a monthly fee to a DPC provider for the majority of their health services. Wisconsin already has some DPC providers, but there are still antiquated insurance regulations on the books that make it more difficult for such providers to operate.
- Create a Dental Therapy License – The creation of a dental therapy license (less than a dentist but more than a dental hygienist) could increase access and lower the cost of routine dental care, particularly in rural Wisconsin where access to dental care is lacking.
- Free Speech in Medicine – Doctors and patients deserve to have all the information necessary when deciding care. But the FDA prevents pharmaceutical companies from freely providing information on off-label uses of prescription drugs. Legislation allowing free speech in medicine has already been passed in Arizona.
- Take full advantage of Short-Term Limited Duration Plans –The Affordable Care Act created uniform insurance regulations that eliminated much of the variety of insurance coverage. But not everyone needs, or even wants the same coverage. Short-term limited duration health plans are a flexible, low-cost alternative that consumers deserve access to. In some cases, these plans can be offered for 90 percent cheaper than traditional insurance coverage. Wisconsin should match the federal government and allow consumers to purchase up to three years of coverage.
- Take full advantage of healthcare freedom in U.S. Territories –Other US states are subject to the same onerous restrictions as Wisconsin under Obamacare, meaning that these states are unlikely to offer significantly cheaper coverage. However, since 2014, US territories have been exempted from many of the more onerous parts of Obamacare, meaning plans might be offered at a significant discount. Wisconsin citizens ought to be able to purchase those insurance plans if they happen to fit their needs.
- Repeal Minimum Markup on Prescription Drugs – Wisconsin’s minimum markup law prevents retailers from selling prescription drugs below cost – even if they want to. Discount retailers aren’t currently able to offer $4 prescriptions on some generic drugs due to the law. There are bipartisan efforts to repeal the minimum markup law. Democratic Senator Tim Carpenter has proposed a bill that would repeal minimum markup when it comes to prescription drugs, while Republican Senators Duey Stroebel and David Craig have proposed a full repeal of the law across the board. Lawmakers should work together to make this change that will have a direct impact on the pocketbook of those with prescription medication.
- Reform Retroactive Eligibility for Medicaid – Controlling the cost of Medicaid without compromising care is critical. Wisconsin should remove any incentive for those eligible for Medicaid to avoid enrollment until after a medical procedure. Nearby states such as Iowa and Indiana received waivers from the federal government to implement this change. While this could potentially lead to a savings for the state—Iowa estimates it’s savings at $36 million in the first year—the more important reason is that enrollment could get people to the doctor sooner for more preventative care that could improve health outcomes.
While the recent Medicaid expansion debate showed the large gap between liberals and conservative on many healthcare issues, all sides ought to be concerned about the same ends—lowering costs and increasing access to care. Policymakers should consider these and other common sense reforms that can move us in that direction.
Cori Petersen is a writer and research analyst at the Wisconsin Institute for Law & Liberty.
Dr. Will Flanders is the research director for the Wisconsin Institute for Law & Liberty.