Trump Administration Promotes Choice, Competition In Health Care

The Trump administration wants to see the nation’s health-care system move away from government mandates and toward a more free-market direction.

In a 114-page report issued this week, Congress and state governments are urged to adopt changes to health insurance and health care providers that have long been favored by conservatives. In addition, the report promotes the greater use of health savings accounts, eliminating barriers to competition and giving consumers more choices in buying health coverage.

The report was issued by the U.S. Department of Health and Human Services, Department of Labor and Department of the Treasury.

In October 2017, President Donald Trump issued an executive order to promote what he described as “health care choice and competition.” The report is the end result of that executive order.

The report summarizes steps the administration already has taken to try to decrease insurance prices by making it easier for individuals to skirt some of the Affordable Care Act’s mandates. From there, the report lists a number of recommendations the administration believes will promote more choice in the marketplace and ultimately reduce the cost of premiums.

The recommendations cover four areas where the administration believes federal and state regulations stifle choice and competition.

1. Health Care Workforce and Labor Markets.  The report recommends policies that will broaden health care providers’ scope of practice while using innovations such as telehealth to meet patient needs more easily. The report also recommends the federal government streamline funding for graduate medical education to address physician shortages.
2. Health Care Provider Markets:  The administration wants to see state action to repeal or scale back Certificate of Need laws and encourage the development of value-based payment models that offer flexibility and risk-based incentives for providers. The report said this especially would help small or rural medical practices.

The administration promoted eliminating the regulations over where hospitals may be built and promoted a slowing-down of health-care industry consolidation. The recommendations urge Congress to make it easier for physicians to build and expand their own hospitals – a practice the ACA essentially stopped. Insurers also should be given the freedom to have fewer doctors in their networks, the report recommended.

3. Health Insurance Markets:  The report recommends scaling back government mandates, eliminating barriers to competition, and allowing consumers maximum opportunity to purchase health insurance that meets their needs. The report especially singled out the ACA requirement that insurers cover many preventive services at no cost to patients as being harmful by driving up the cost of care and leading to unnecessary treatment.

4. Consumer-Driven Health Care:  The report recommends expanding access to HSAs, implementing reference pricing where appropriate, and developing price and quality transparency initiatives to help consumers make informed decisions about their care.