Editor's note: below is Joseph Antos' response to Modern Healthcare's question: "What should the president say about health care in the State of the Union address?" Other health industry leaders' responses can be found here.
Instead of advancing another round of fee cuts that will never be implemented, change the incentives that drive Medicare spending and give seniors a choice of plans that compete on an even basis. Let states do a better job of operating their Medicaid programs by giving them full flexibility rather than requiring them to seek waivers for even small changes. Give states that accept that flexibility a predictable federal subsidy based on the number of people served, not the volume of services provided. Introduce a more realistic understanding of what it takes to implement the Affordable Care Act.
At least 20 states will not create a state insurance exchange, and most of the others face great difficulties in making it work. They need more time, and so does the federal government. A delay, allowing states to move at their own pace, is the only responsible action—but one that will be especially difficult for this president.