TSI Op-Ed: Understanding policy trade-offs in the health care debate


Op-Ed by Laura Berlind

July 8, 2017 — Understanding the trade-offs involved in the next step to address problems in our existing health insurance system is important for Tennesseans.

Two of the Affordable Care Act’s primary trade-offs include helping the sick and elderly afford private insurance by mandating participation and increasing costs for the young and healthy and, secondly, covering more people through Medicaid by increasing federal taxes and spending.

The U.S. House of Representatives’ bill and the Senate’s current efforts to partially repeal and replace the ACA does more-or-less the reverse. If the American Health Care Act becomes law:

  1. Health insurance premium costs in the individual market are likely to fall for young and healthy people while rising for older and less healthy people.
  2. New federal spending caps will limit the growth of federal Medicaid funding, which could require states to find new efficiencies, spend more of their own money, or reduce Medicaid coverage, eligibility or provider payments.

The Sycamore Institute, a nonpartisan research center, took a look at what the bill’s core trade-offs mean for two specific groups – the 1.5 million Tennesseans living in rural areas (22 percent of our population) and the 150,000 with disabilities covered by TennCare, our state’s Medicaid program (accounting for 35 percent of the program’s medical costs).

Read the full op-ed.