Sen. Cassidy Plans Obamacare Alternative

‘Patient Freedom Act’ proposes way forward following King v. Burwell decision

Sen. Bill Cassidy of Louisiana / AP
June 2, 2015

Freshman Sen. Bill Cassidy (R., La.) wants the GOP to start thinking like the left.

In proposing the Patient Freedom Act, Cassidy believes he is doing just that—slowly chipping away at Obamacare by bringing federalism back into the health care system and getting the federal government out.

"Of course it would be wonderful [to repeal Obamacare now]," Cassidy told the Washington Free Beacon. "But as Paul Ryan says, President Obama is not going to sign a repeal of Obamacare."

"The left was really good for decades—they were pushing, and pushing, and pushing [for health care reform]," Cassidy said. "We’re impatient. We want it all at once."

"I think we have to be as strategic as they," he said. "Plant those seeds, water, show people our alternative, and inch back."

Cassidy’s bill proposes a way forward following the Supreme Court’s decision in King v. Burwell, which is expected by the end of June. The case will decide whether the majority of health exchanges, which are run by the federal government, are legally allowed to provide subsidies.

Cassidy, a doctor who unseated Mary Landrieu (D., La.) last November, narrowly focused his bill to be a response to a ruling in favor of Burwell, which would take away subsidies in states that are operated by the federal exchange. Only 13 states operate their own health insurance marketplaces, since the $205 million Hawaii exchange announced it would fold and be taken over by the federal government.

The Patient Freedom Act would give states the option of keeping Obamacare by establishing a state-based exchange, or using existing funding to provide tax credits to create Health Savings Accounts (HSAs) for the uninsured, averaging $1,500 per person.

"We are trying to give the state an option other than setting up an Obamacare exchange," Cassidy said.

"The president, I’m sure, will make it easy [to set up a state exchange], because he wants his law to take root," he said. "If we don’t have a better plan, it will take root."

If states chose Cassidy’s option, they could do away with various mandates under Obamacare, including the individual and employer mandates and requirements for minimum essential coverage. The legislation would also equalize tax treatment, and require health providers to publish cash prices for services reimbursed from an HSA.

Price transparency would enable patients to know the price before booking an appointment for medical services such as a CAT scan, which Cassidy said can range between $100 and $2,500 depending on the time of day.

"Under Obamacare, you have a $6,000 deductible," Cassidy said. "People are forgoing good care because they can’t afford a $6,000 deductible. Under the Health Savings Account (HSA) we have first-dollar coverage. Your daughter has an earache, you bring her to the doctor and the doctor will be covered. We with our HSA actually have first dollar coverage for that which people need most."

Cassidy’s bill borrows from other Republican alternatives to Obamacare in Congress, such as Rep. Tom Price (R., Ga.), whose replacement plan also offers tax credits. Cassidy said his is the only plan that would solve the gap in coverage if the Supreme Court does away with Obamacare subsidies.

"We’ve got three options: Some woman receiving chemotherapy for breast cancer paying far more than she should for health insurance because of Obamacare mandates loses the Obamacare subsidies and can’t afford her insurance and loses her care," Cassidy said. "That’s the president’s fault for implementing the law illegally, but quite likely he’ll successfully blame us."

"Second, the president, in order to alleviate her problem, will say, ‘All Republicans have to do in the Senate and the House is deem federal exchanges state exchanges for the purposes of receiving subsidies," he continued. "Or go to governors, and say, ‘Governor, why don’t you just set up a state exchange? We’ll make it easy for you, and preserve her health care."

"The third option is we have a plan," Cassidy said. "And we can credibly say we’ve got something better."