November 4, 2016
Interview: Avik Roy on the Right Way to Replace Obamacare
November 4, 2016
On November 3,
of the
spoke at length with FREOPP President Avik Roy about FREOPP’s health reform proposal, Transcending Obamacare: A Patient-Centered Plan for Near-Universal Coverage and Permanent Fiscal Solvency.
“In a speech earlier this week,” Dwyer wrote, “Donald Trump and running mate Mike Pence harshly criticized the Affordable Care Act. ‘Obamacare has to be replaced. And we will do it, and we will do it very, very quickly. It is a catastrophe,’ Trump said.
“While the Trump plan fails to provide a realistic replacement for the ACA, there is bipartisan agreement that the instability in the ACA’s individual health-care markets needs to be addressed…So where does that leave the Affordable Care Act? Are there solutions that might gain bipartisan support?”
She continues:
To find out, we sat down with
Avik Roy, a conservative health-care policy wonk and former advisor to
Rick Perry, and
Marco Rubio. Roy has garnered quite a bit of attention in recent months for his criticism of the Republican party’s current nationalistic bent. Roy is also the founder of FREOPP, a new free market think tank focused solely on policies to improve the economic fortunes of low-income Americans — the think tank is, according to its mission statement, “an attempt to resuscitate the model of non-partisan policy research that can attract the support of policymakers on both sides, by adopting as its cause a principle that nearly all Americans support: equality of opportunity.”
In September, Roy released the second edition of Transcending Obamacare (the first edition was released in 2014), a comprehensive plan to reform the Affordable Care Act in accordance with more conservative, free-market principles. The plan, which does not require a formal repeal of the ACA, is notable both because it offers solutions that might garner bipartisan support and because it is the only mainstream conservative proposal that provides near-universal health insurance coverage — in fact, Roy’s model claims that the FREOPP plan, dubbed the Universal Tax Credit plan, would insure more people than the ACA currently does.
Similar to the Affordable Care Act, the FREOPP plan proposes providing generous means-tested subsidies for the purchase of health insurance. However, the plan calls for a shift toward a system that combines catastrophic plans for expensive health emergencies and health savings accounts (HSAs) for more routine health costs. The FREOPP plan also calls for the gradual transfer of most Medicaid recipients — a cause of some controversy — and younger retirees into the private insurance market (with the aforementioned subsidies). In addition, the FREOPP plan does away with the individual mandate and some (although not all) of the requirements and regulations the ACA imposed on insurers and insurance plans, the latter of which Roy argues would decrease the cost of health insurance and, thus, increase the enrollment of young, healthy people.
In the interview, Dwyer and Avik discuss the mechanics of how the FREOPP plan would work; the role of health savings accounts and catastrophic coverage; improving the risk pool for people buying coverage on their own; regulatory reform; and how the FREOPP plan compares to House Speaker Paul Ryan’s plan to replace the Affordable Care Act.
Avik argues that the ACA needs, at the very least, significant reform. “The real problem we needed to solve,” he says, “was not how to make coverage more attractive to sick people, [but] how do we make coverage more attractive to healthy people who are lower-income. And what the ACA did was it made health insurance very, very expensive for lower-income people who are healthy.”
