Four Thoughts About Rick Perry’s Four-Point Health Care Plan

Rick Perry’s campaign has laid out a very preliminary outline of his health care proposal. The plan is a boilerplate concoction of GOP “consumer-driven” ideology that seeks to repeal the Affordable Care Act, deregulate the health insurance marketplace, and shift the responsibility of dealing with the health care crisis to the states. Below are Perry’s four main proposals and my analysis of each:

1) Work with Congress to repeal “Obamacare”: The Congressional Budget Office estimates that eliminating the law would increase the deficit by $230 billion over 10 years, raise the number of uninsured by 32 million, eliminate subsidies and force millions of American families to pay higher premiums, and increase premiums for employer-based coverage.

2) Stabilize the country’s economy for employers, “free states from federal mandates and empower them to develop innovative solutions”: Perry had 11 years to develop an “innovative” state solution, but all we see from his tenure is skyrocketing uninsurance rates in Texas and premiums that are higher than the national average. Still, some states are genuinely interested in lowering costs and expanding coverage, and the Affordable Care Act allows them to do just that — it waives some of the requirements of the law and permits states to design their own reforms, as long as they can meet the same coverage and cost benchmarks.

3) Lower skyrocketing health care costs “through the proven, market-based strategies of transparency, choice and competition”: Again, it’s unclear what kind of policy he’s proposing, since the insurance exchanges that are part of the Affordable Care Act already offer “choice and competition.” But if past Republican proposals are any indication, he’s likely considering allowing insurers to circumvent state consumer protections and sell their policies across state lines. Under this approach, companies would have little incentive to do business in states that require coverage for cancer screenings or have guaranteed issue protections and will instead sell plans across the country that deny coverage altogether to high-cost beneficiaries.


4) Implement Texas-style health care reform: The current health care law already includes similar demonstration projects, even if the Congressional Budget Office has concluded that malpractice reforms could at most save $54 billion over 10 years. When Texas capped non-economic medical malpractice damages to $250,000 in 2003, most conservatives argued that the reform would free doctors from having to prescribe unnecessary treatment to avoid lawsuits. It didn’t work out that way. In fact, Texas’ Medicare spending seems to have actually gone up faster than the nation’s since 2003.