2016 GOP platform calls for Obamacare repeal, reform Medicare

When it comes to healthcare policy, the official 2016 Republican Party platform under presumptive presidential nominee Donald Trump remains largely unchanged from the platform approved in 2012.

The 2016 platform, approved by Republican delegates Monday (July 18) on the first day of the Republican National Convention in Cleveland, calls for the same broad-brush reforms as the platform approved four years ago when Mitt Romney was the nominee.

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At the center of the Republican approach is the idea that a simpler system with patient choice at the center can provide all Americans with affordable care, reduce costs of the overall system and preserve the financial stability of Medicare and Medicaid.

“We must recover the traditional patient-physician relationship based on mutual trust, informed consent, and confidentiality,” the platform reads. “To simplify the system for both patients and providers, we will reduce mandates and enable insurers and providers of care to increase healthcare options and contain costs.

“This is an agenda to improve healthcare, not just to manage its costs,” it continues. “We reject the Democrats’ approach of rationing inherent in Obamacare. We recognize the de facto rationing of healthcare caused by reduced access to doctors who increasingly opt out of participating in Medicare and Medicaid.”

The key provisions include:

·      Repeal and replace the Affordable Care Act (ACA), aka Obamacare;

·      Leave Medicare untouched for Americans over 55 years of age but provide the choice of premium support for future seniors to protect the program’s financial solvency and provide more patient choice;

·      Convert Medicaid into a block-grant program

·      Supports the passage of the Comprehensive Addiction and Recovery Act to fight the opioid crisis, and ensure the U.S. Centers for Medicare & Medicaid Services (CMS) does not punish doctors for limiting opioid prescriptions; and

·      Allow the sale of health insurance policies across state lines to increase competition and lower prices.

Below are excerpts from some of the key sections of the platform:

Repeal Obamacare

“Any honest agenda for improving healthcare must start with repeal of the dishonestly named Affordable Care Act of 2010: Obamacare. It weighs like the dead hand of the past upon American medicine.”

Next: What to replace it with

What to replace it with

Increase state control, limit mandates that increase cost of care. “Our goal is to ensure that all Americans have improved access to affordable, high-quality healthcare, including those struggling with mental illness. We will return to the states their historic role of regulating local insurance markets, limit federal requirements on both private insurance and Medicaid, and call on state officials to reconsider the costly medical mandates, imposed under their own laws, that price millions of low-income families out of the insurance market.”

Further reading: Internist fed up with Trump organizes protest at RNC

Create price transparency. “To ensure vigorous competition in healthcare, and because cost-awareness is the best guard against over-utilization, we will promote price transparency so consumers can know the cost of treatments before they agree to them. We will empower individuals and small businesses to form purchasing pools in order to expand coverage to the uninsured.”

Preserve protection for patients with pre-existing conditions. “We believe that individuals with preexisting conditions who maintain continuous coverage should be protected from discrimination.”

Supports health information technology and electronic health records. “We applaud the advance of technology in electronic medical records while affirming patient privacy and ownership of personal health information.”

Related: Will Republican proposals to replace Obamacare make America healthier?

Make health insurance portable. “Consumer choice is the most powerful factor in healthcare reform. Today’s highly mobile workforce needs portability of insurance coverage that can go with them from job to job. The need to maintain coverage should not dictate where families have to live and work.”

Allow insurance to be purchased across state lines. “We propose to end tax discrimination against the individual purchase of insurance and allow consumers to buy insurance across state lines. In light of that, we propose repealing the 1945 McCarran-Ferguson Act which protects insurance companies from anti-trust litigation.”

Promote health savings accounts. “We look to the growth of Health Savings Accounts and Health Reimbursement Accounts that empower patients and advance choice in healthcare.“

Medicare: Leave it unchanged now, reform later

“We propose these reforms: Impose no changes for persons 55 or older. Give others the option of traditional Medicare or transition to a premium-support model designed to strengthen patient choice, promote cost-saving competition among providers, and better guard against the fraud and abuse that now diverts billions of dollars every year away from patient care. Guarantee to every enrollee an income-adjusted contribution toward a plan of their choice, with catastrophic protection. Without disadvantaging present retirees or those nearing retirement, set a more realistic age for eligibility in light of today’s longer life span.”

Next: Opioid crisis, Medicaid

Turning Medicaid into a block grant program

“We applaud the Republican governors and state legislators who have undertaken the hard work of modernizing Medicaid. We will give them a free hand to do so by block-granting the program without strings. Their initiatives-whether premium supports for purchasing insurance, refundable tax credits, alternatives to hospitalization for chronic patients, disease prevention activities, and other innovations-are the best strategy for preserving Medicaid for those who need it the most.”

Solving the opioid crisis

“Because over-prescription of drugs is such a large part of the problem, Republican legislation now allows Medicare Part D and Medicare Advantage plans to limit patients to a single pharmacy. Congressional Republicans have also called upon the Centers for Medicare and Medicaid Services to ensure that no physician will be penalized for limiting opioid prescriptions. We look for expeditious agreement between the House and Senate on the Comprehensive Addiction and Recovery Act, which addresses the opioid epidemic from both the demand and supply sides of the problem.”

Allow veterans to seek care from community physicians and providers

“Injuries [suffered by veterans] require a new commitment of targeted resources and personnel for treatment and care to advance recovery. That includes allowing veterans to choose to access care in the community and not just in VA facilities, because the best care in the world is not effective if it is not accessible.”

Medical Economics is reporting all week from Cleveland, Ohio, during the Republican National Convention. For more coverage, visit our 2016 Election page.