A conservative group funded by the Koch brothers is pushing for high-risk pools and a freeze on Medicaid expansions as lawmakers try to coalesce around a replacement for ObamaCare.
Freedom Partners began circulating a memo on Capitol Hill Monday with specific reforms it thinks lawmakers should pass, including: the creation of high-risk pools at the state level to cover people with pre-existing conditions; the elimination of the ObamaCare mandate, which required everyone buy insurance or pay a penalty; and the expansion of access to health savings accounts, so people can save and pay for healthcare with pre-tax dollars.
The recommendations fall in line with what top Republicans in Congress have indicated they support.
Tom Price, President Trump’s pick to lead the Department of Health and Human Services, proposed the implementation of high-risk pools in a bill he introduced in 2015. In that same bill, he also pushed for the expansion of health savings accounts.
Freedom Partners also recommends an immediate freeze of the Medicaid expansion, with no new enrollees added who don't quality under pre-ObamaCare standards.
The group suggests the use of block grants or a per-capita cap on funding to give states “maximum flexibility," though critics argue such a move would cut funding and benefits for Medicaid.
Republicans are relatively united in calls to block grant Medicaid, meaning that instead of an open-ended federal commitment, states would have a set amount of funding to draw from to cover low-income people.
Block grants are heavily favored by Trump. A top Trump adviser said last week that giving each state a fixed amount of federal money in the form of a block grant would be included in the ObamaCare replacement. Trump has also expressed support for high-risk pools.
Other recommendations from Freedom Partners include: allowing the purchase of insurance plans across state lines; eliminating the coverage requirements established under ObamaCare and giving states complete regulatory authority over health plans.