Columbus, OH – The Buckeye Institute released a report today on how states can grow their health care markets in 2017. The free-market organization’s proposals consider what states should do if parts of the Affordable Care Act (ACA) are repealed or kept intact.

In Health Care Challenges That States Should Prepare to Face in 2017, Rea S. Hederman Jr. of The Buckeye Institute and Brian Blase with the Mercatus Center at George Mason University propose ways states can prepare for potential federal changes to the ACA and Medicaid by reducing health insurance prices and expanding the supply of service providers.

If a Republican wins the presidency this November and repeals key components of the ACA, Hederman and Blase say states should curb ACA-compliant mandates, create protections for people with pre-existing conditions, and institute reformed high-risk pools.

Should the ACA remain intact under a Democratic president, the authors caution against using an ACA provision, Section 1332, as a compromise. That waiver, they say, is difficult to obtain, has stringent requirements, and impedes state efforts to increase choice and lower costs.

Regardless of who wins the White House, the authors say states can pursue “supply-side reforms,” such as removing certificate of need (CON) rules and increasing charity care and “telemedicine.”

Today 36 states, including Ohio, have CON programs, requiring that health care suppliers get government approval before expanding services or building new facilities. Current charity care regulations also prevent licensed professionals from providing free services to low-income residents in other states or different parts of their own state.

Cutting regulations on telemedicine, in which doctors diagnose minor illnesses and prescribe medicine online, is another way states could expand services, according to the authors.

“People will struggle finding quality health care in 2017 if policymakers don’t take action to free up providers from burdensome state regulations,” Hederman, executive vice president of The Buckeye Institute, said. “Reforming state regulations will improve the quality of health care, cut costs, and increase access, particularly for disadvantaged families.”

States also should expect federal changes to Medicaid spending—with Republicans proposing $1.3 trillion in savings over a decade and Democrats trimming $100 billion over 10 years. Hederman and Blase promote work requirements for non-disabled adults, cost-sharing programs, and modified benefit packages as ways states could maintain coverage at reduced cost.

“As Washington finally considers how to replace the ACA and the necessity of Medicaid reform is made clear, states must work with Washington on reforms that increase the value from health care programs,” Blase, a senior research fellow at the Mercatus Center, said. “States should push for the ability to reform Medicaid and provide options tailored to their residents without having to go through the federal government's politicized waiver process.”

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