Voter Guide: Health Reform Overview
Proposals for Health Reform
Medicaid Block Grants
Medicaid is currently a federal-state partnership. The federal government provides at least 50% of the funds and establishes some baseline requirements. States run the program and provide the remaining funds. Some candidates would like the federal government to give states more power to design their program. The proposals would give states a set amount of money based on a calculation, such as the number of uninsured in a given state, and allow the states to design and run the program as they see fit.
Allow Insurance to Be Sold Across State Lines
Under current law, an insurance company must be licensed and bonded in every state in which they sell. Some candidates would like to change that by allowing insurance companies that meet one state’s standards to sell in any state.
Negotiate on Medicare Drug Prices
The federal government is prohibited from negotiating prices with drug companies for the drugs used by Medicare beneficiaries. Some candidates would like to change that prohibition and require Medicare to negotiate better drug prices on behalf of all beneficiaries.
Medicare Premium Support
Some candidates would like to “privatize” Medicare by giving beneficiaries a fixed dollar contribution toward the purchase of a private health plan. If the plan chosen costs more than the federal contribution, individuals would pay the difference.
Raise Medicare Eligibility Age
Most Americans become eligible for Medicare when they turn 65. In order to save money and extend the life of the Medicare trust fund, some candidates have called for increasing the eligibility age for new beneficiaries to 67 or 70.
Expand Health Savings Accounts
Currently, individuals with a high deductible health plan can open up a health savings account (HSA) to contribute pre-tax dollars toward the cost of future medical expenses. The value of the account rolls over from year to year if the money is not spent. There are limits on how much individuals can contribute to HSAs. Some candidates would like to increase those limits and eliminate some of the other restrictions in order to make HSAs more widespread.