Affordable Care From Obamacare? Senators Disagree

Don’t tell politicians the fight over Obamacare is essentially over.

A better alternative, he continued, is the bill he introduced this spring ahead of the Supreme Court’s ruling on the Affordable Care Act. The measure would direct federal subsidies to consumer health savings accounts, an approach he contends would cut health spending by exposing patients to more out-of-pocket costs, which in turn would force them to pay closer attention to their health spending.

“The literature says they create an activated patient,” said Cassidy, a former gastroenterologist who now serves on the Health, Education, Labor and Pensions Committee. “They have lower costs and improved outcomes.”

Sen. Debbie Stabenow, D-Mich., who joined Cassidy on Tuesday’s panel, was not convinced. While “there’s a lot of work left to do” to accomplish the Affordable Care Act’s goals of improving treatment and reining in costs, she said, “this is just the beginning” and the law “has made some strides.”

The way forward, Stabenow continued, is not exposing more patients – and especially low-income patients – to more costs, but instead finding ways to provide doctors and health administrators greater flexibility for providing affordable care.

“Unleash the creativity of health care professionals. … That’s what we want to incentivize: the opportunity to create the better way,” said Stabenow, ranking member of the Senate Finance Subcommittee on Health Care.

That can include more effectively integrating and harnessing telemedicine and electronic health records, setting nationwide standards for maternal and infant health care (as a Stabenow bill would do) and better incorporating mental health care.

“It’s received more focus now because of the discussion around violence and gun violence and so on,” Stabenow said. “It has needed discussion by itself for a long time. When we talk about integrated care, the ultimate integrated care is to make sure we’re treating diseases above the neck the same way we treat diseases below the neck.”

This kind of structure, she added, compared to the less restrictive health savings account-focused approach, is what helps patients seek preventative care and prevents them from using emergency rooms as their only sources of treatment.

Patrick Pilch, head of the health care advisory practice at the consulting firm BDO, also took part in the panel, finding “agreement actually more than I hear disagreement. They’re just coming from different perspectives.”

And five years after the Affordable Care Act was signed, that prompted one attendee to ask, “When are we going to move beyond debate over the law and move to a framework for value? When are we going to move forward? … Because we know we’re not moving back.”