Nearly 50 of the most prominent health policy experts and academics in California and around the country released a statement sharply critiquing the recently-proposed health proposals of U.S. Senate candidate Carly Fiorina, indicating her solutions to “repeal and replace” the new federal health law would have significant negative consequences with little benefit. Noam Levey of the Los Angeles Times has more.
“Carly Fiorina’s most recent statements suggest that she endorses the standard Republican ‘solution’ to the health care problems of the U.S.: extending the enormous tax subsidies already available for employer-provided health insurance,” wrote the health policy experts in a statement. “This policy would promote the unraveling of employer sponsored insurance, leaving millions at the mercy of the discriminatory non-group market.”
“As a result, Fiorina’s plan will simply result in a loss of federal and state tax revenues with little improvement to the functioning of insurance markets in the U.S., little reduction in the number of uninsured, and displacement of many who are happy with their existing insurance arrangements,” concluded the experts.
The statement was quickly written and signed-onto by the experts in response to remarks made by California candidate Carly Fiorina just last week at a conference of underwriters in California, in which she, for the first time in this campaign at this late date, described some specifics on what she would do on health care policy beyond repealing the federal health law. According to the October 21 San Jose Mercury News, Fiorina criticized the Affordable Care Act as “flawed in that it puts 16 million uninsured people into Medicaid…. she did not say how those individuals should get health coverage. Instead, she advocated a system in which employees would ‘own’ their health insurance and insurers would compete for clients. Employees would receive the same tax breaks for health insurance costs as employers and would be able to take their insurance with them if they change or lose jobs.”
The prominent national and California health experts and academics listed wanted to be clear about what such a “repeal and replace” proposal would mean for California families and patients. The list of 49 experts includes academic and analysts of a range of disciplines, ideological positions, and expertise in state and national health policy discussions, such as E. Richard Brown at the UCLA Center for Health Policy Research, MIT economist Jonathan Gruber, and Henry Aaron of the Brookings Institute. Health Access California does not endorse candidates, but assisted in distributing the statement as part of its ongoing effort educating people about health reform and different policy proposals.
This statement–by the who’s who of health policy experts–helps provide new accountability to the health policy debate in political campaigns this fall. Candidates like Fiorina who have taken a “repeal and replace” position on the new federal health law have generally not been called to account on what they would “replace” the federal health law with–not to mention what the impact of those proposals would be, and whether they would even work. Here is the statement in its entirety:
The Fiorina “Plan” Will do Little to Reform Health Care in the U.S.
Carly Fiorina’s most recent statements suggest that she endorses the standard Republican “solution” to the health care problems of the U.S.: extending the enormous tax subsidies already available for employer‐provided health insurance. The U.S. already spends $250 billion per year subsidizing employers to offer insurance. This has resulted in a system where most Americans have coverage with which they are fairly satisfied – but where Americans left out of the employer‐provided system comprise the majority of the uninsured. These individuals are subject to an overpriced and discriminatory “non‐group” market, where insurance is expensive and unreliable, where insurance can be cancelled or over‐priced when children or adults become sick or injured, or where insurers can exclude coverage for past illnesses.
The recently enacted health care reform, the Patient Protection and Affordable Care Act (PPACA) addresses these problems by:
* Prohibiting insurers from charging people more for coverage based on their pre‐existing health conditions.
* Prohibiting insurers from excluding pre‐existing conditions from coverage.
* Subsidizing the cost of insurance so that it is more affordable for moderate‐income and lower‐income families.
* Reforming insurance markets through competitive exchanges which lower prices and improve consumer choice.
The result is a reformed system which will provide new insurance coverage to 32 million Americans, while offering an even larger number of people improved protection against the risk of medical bankruptcy.
While Fiorina has provided little detail, her statements suggest that she endorses the standard Republican approach of simply extending the existing tax subsidy to the purchase of non‐group insurance as well as employer-provided insurance. This approach fails to address the problems noted above because:
* Most workers who are offered health insurance by their employers are already enrolled. So offering new tax breaks to them will do little to increase coverage.
* About half of the uninsured have low incomes and therefore don’t pay enough income taxes to benefit from a tax deduction for health insurance.
* There is nothing in this plan to address the discriminatory and high priced coverage options now facing those without an employer offer.
* This policy would promote the unraveling of employer sponsored insurance, leaving millions at the mercy of the discriminatory non‐group market.
As a result, Fiorina’s plan will simply result in a loss of federal and state tax revenues with little improvement to the functioning of insurance markets in the U.S., little reduction in the number of uninsured, and displacement of many who are happy with their existing insurance arrangements.
PPACA reforms insurance markets and truly provides the type of choice that Fiorina advocates: choice on a level playing field where insurance is efficiently provided, fairly‐priced, and available with subsidies which make coverage genuinely affordable. Repealing PPACA and replacing it with this alternative would mean 32 million fewer insured Americans and the continuation of a broken and discriminatory health insurance market.
* Jonathan Gruber, Professor of Economics, Massachusetts Institute of Technology
* Judith Feder, Professor of Public Policy, Georgetown Public Policy Institute
* Ken Jacobs, UC Berkeley Center for Labor Research and Education
* Harold Pollack, Helen Ross Professor of Social Service Administration and Faculty Chair, Center for Health Administration Studies, University of Chicago
* J. Bradford DeLong, Professor of Economics, University of California at Berkeley
* Theda R. Skocpol, Victor S. Thomas Professor of Government and Sociology, Harvard University
* Linda Bergthold, Ph.D., Independent Consultant and Researcher
* Colleen Grogan, Professor, School of Social Service Administration, University of Chicago
* Mark A. Peterson, Professor of Public Policy and Political Science, UCLA School of Public Affairs
* Sara Rosenbaum, Hirsh Professor and Chair, Department of Health Policy, George Washington University
* E. Richard Brown, Professor, UCLA School of Public Health, Director, UCLA Center for Health Policy Research
* Gerald F. Kominski, Professor, UCLA School of Public Health
* Barbara Starfield, M.D. Professor of Health Policy, Johns Hopkins Bloomberg School of Public Health
* Joseph Andresen, MD., Editor, Santa Clara County Medical Society Bulletin
* Helen Ann Halpin, Professor, University of California, Berkeley School of Public Health
* Dean Baker, Co‐Director, Center for Economic and Policy Research
* David Cutler, Otto Eckstein Professor of Applied Economics, Harvard University
* Austin Frakt, Assistant Professor, Boston University School of Public Health
* Arindrajit Dube, Department of Economics, University of Massachusetts‐Amherst
* Dylan H. Roby, Assistant Professor of Health Services, UCLA School of Public Health
* Janet Coffman, Assistant Adjunct Professor, University of California San Francisco
* Clarissa K. Wittenberg, Health Care Consultant
* Theodore Marmor, Professor Emeritus, Yale School of Management
* Rick Mayes, Associate Professor of Public Policy, University of Richmond
* G. Caleb Alexander, Assistant Professor, University of Chicago
* Alan B. Cohen, Professor, Executive Director Boston University Health Policy Institute
* Jonathan Oberlander, Professor of Social Medicine and Health Policy & Management, UNC‐Chapel Hill
* Enku Kebede‐Francis,Assistant Professor, Tufts University Medical School
* Brian R. Flay, Professor, Public Health, Oregon State University
* Robert F. Coulam, Professor, Director of the Center for Health Policy Research, Simmons College School of Management
* Joseph Restuccia, Professor of Health Care and Operations Management, Boston University School of Management
* Randall P. Ellis, Professor, Boston University, President, American Society of Health Economists
* Ted Joyce, Professor of Economics, Baruch College and Graduate Center, City University of New York
* Ronald Bayer, Professor and Co‐Chair, Center for the History & Ethics of Public Health, Mailman School of Public Health
* Stephen M. Davidson, Professor, Boston University School of Management
* Donald H. Taylor, Jr., Associate Professor of Public Policy, Duke University
* Michael Shwartz, Professor of Health Care and Operations Management, School of Management, Boston University
* Michael L. Millenson, The Mervin Shalowitz, MD Visiting Scholar, Kellogg School of Management, Northwestern University
* Michael Reich, Professor of Economics, Director, Institute for Research on Labor and Employment, UC Berkeley
* Ed Yelin, Professor of Medicine, University of California San Francisco
* Sam Bozzette, Professor of Medicine and of International Relations, University of California San Diego
* William Terry, MD, Center for Interdisciplinary, Cardiovascular Sciences, Brigham and Women’s Hospital
* Steve Shortell, Dean and Professor, UC Berkeley School of Public Health
* Peter D. Jacobson, Professor, Director, Center for Law, Ethics, and Health, University of Michigan School of Public Health
* Harry P. Selker Professor of Medicine, Director of the Clinical Research Program, Tufts University School of Medicine
* Meredith Rosenthal, Associate Professor of Health Economics and Policy, Harvard School of Public Health
* Diane S. Lauderdale, Professor, Epidemiology Department of Health Studies, University of Chicago
* Arleen Leibowitz, Professor of Public Policy, UCLA School of Public Affairs
* Henry J. Aaron, Bruce and Virginia MacLaury Senior Fellow, The Brookings Institution
(Titles and institutions are listed for informational purposes only.)