Cost estimates for a PPACA replacement plan

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Article Highlights

  • People who maintain continuous insurance coverage should be granted new protection regarding their insurance premiums

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  • Households not enrolled in employer-based insurance should be eligible for a tax credit for private coverage

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  • States, not the federal government, would establish the rules for required insurance benefits

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The Patient Protection and Affordable Care Act (PPACA) has now survived legislative, judicial, and electoral challenges.  Those apparent successes notwithstanding, the PPACA remains a sweeping – and damaging – reform of the health care delivery, health entitlements, and health insurance sectors in the United States.  Its policy flaws are myriad.  With its most significant provisions scheduled to take effect in 2014, advocates for an alternative reform have two apparent options: repeal and replace the PPACA when the time is right, or undertake sequential reforms intended to improve its policy outcomes.  Of course, in the current political context, neither appears promising.  Nevertheless, there is merit to continued evaluation of full-scale alternatives to the PPACA.  One common defense of the law is that there has been no competing alternative, which is not true.  But there is virtue to continuing to develop and refine as many alternatives as may be proposed.  Toward that end, this short paper outlines one practical, conservative approach to replacing the law with a market-based reform plan.

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James C.
Capretta

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