Is State-Driven Healthcare Coming?

Groups are still working to overturn Obamacare with block grants to states.
Conservative groups, including the Heritage Foundation, Galen Institute, former Senator Rick Santorum (R-PA), and others, have released a proposal for repealing Obamacare. While the proposal does not create the consumer-driven, parallel healthcare system that ANH-USA advocates, it contains many ideas and reforms that would break the straight-jacket that is constraining our health insurance market—and could pave the way to the parallel healthcare system we’d like to see develop nationwide.
The plan contains many of the same proposals as the Graham-Cassidy bill that failed to pass in 2017. Essentially, the idea is to turn health insurance over to the states. If California wants to create a single-payer system, it would allow it to do so. If another state likes Obamacare, it can keep it. If another wishes to create a consumer-driven system, then it allows that. This is accomplished through converting Obamacare’s Medicaid expansion and subsidies to block grants to states to set up their own healthcare markets. Giving states this freedom is a positive step, especially since some have indicated already they are eager to move down a more consumer-driven path.
Although the penalty for not purchasing insurance has been eliminated, it’s still the law that Americans must buy insurance, and that insurance still needs to follow Obamacare requirements in most cases. This plan promises to eliminate the red tape created by Obamacare and to allow states to innovate solutions to keep premiums down: “States would no longer be bound by Obamacare’s mandates such as essential health benefits, minimum loss ratio requirements, single risk pools, and 3:1 age rating requirements.”
Eliminating essential health benefits and single risk pools are key reforms for which ANH has been fighting. Essential health benefits mean that insurers must cover a range of services by law, including drug rehab and pregnancy services, which many of us will never use. If you want a plan that doesn’t cover those services, tough luck.
Freeing states from single risk pools is also crucial. ANH has long fought for catastrophic-only plans to be available, the idea being that consumers interested in integrative healthcare not covered by normal insurance could purchase a bare-bones plan, then pay out of pocket for integrative services. Under Obamacare, bare-bones plans are not available to most consumers, so those who want integrative services have to pay for a full healthcare plan they won’t use, in addition to integrative services. Some reform efforts proposed the sale of catastrophic-only plans, but kept them in the same risk pool as other plans—meaning that when older, sicker Americans purchased more expensive Obamacare plans, the cost of cheaper plans would go up to compensate. Allowing separate risk pools, as this new plan does, will address this issue and allow affordable plans to be offered.
HSAs (health savings accounts) also get a mention in the new proposal. The proposal promises to “roughly double” the maximum HSA contributions for individuals (currently capped at $3,450) and families (currently capped at $6,850), although no specific figures are offered, and makes HSAs compatible with more plans. ANH has long-supported expanding HSAs, especially to cover supplements, though it’s unclear whether the proposal will include that reform, as there is no official legislative language yet.
ANH prefers a consumer-led system that would be available to residents of all states. In fact, a consumer-led system could even coexist with Obamcare, and people could decide for themselves which option they prefer.  But this new approach would be better than the existing system, which is at risk of collapse. Allowing states to do their own thing would also provide many experiments that would be useful in establishing what works and what does not. States would have to take this seriously because they compete with each other. Those who make the wrong choices would see their economic prospects fade while other states add employers and jobs.


  1. Universal coverage that INCLUDES integrative health care would be better than a system that still required everyone to pay out of pocket, even if they were paying far less than the current exorbitant costs for insurance. An awful lot of Americans would still not be able to afford treatment.
    Here in New Mexico, most health insurance includes coverage for acupuncture, so most of my patients are using insurance. However, straight Medicare doesn’t cover acupuncture or any other services by licensed acupuncturists. Fortunately, many of my senior patients are covered through Medicare Advantage plans. Even though they have insurance with relatively small premiums, expecting them to pay full price out of pocket for integrative health care on what’s left of their incomes would be unrealistic for a lot of them. For the lower-income folks, it’s a big deal to spend even $10. I treat them at an extreme discount, but there’s a limit to how much that can be done, and it doesn’t solve the big-picture problem.

  2. Forcing people to buy insurance is a problem because simply having insurance is no guarantee of getting your health care costs paid for. Part of the reason why health care costs are so high in the US is our cultural reliance on extremely expensive pharmaceuticals that oftentimes don’t really work (or make things worse). We need a revival in herbal medicine and other traditional healing modalities and reserve the pharmaceuticals for last resorts. Free medicine for the people – plants in your own backyard. Some work just by eating fresh leaves (like dandelions for digestion), so you can’t get any easier than that.
    Also, I believe that as our dietary habits start to change back to more traditional food, incidences of disease will decrease. Now that trans fats are finally being phased out, will we see fewer heart attacks? People are switching back to using real butter, coconut oil is lining grocery shelves, more varieties of produce are becoming available. I also keep seeing articles and documentaries exposing the low-fat myth and the dangers of excessive sugar. Word is getting out and people ARE changing their habits. Yes, ultra-processed food is still far too popular, but I predict this will change dramatically within the next decade or so.

    1. I don’t know what it’s like where you are, but here in New Mexico we have quite a bit going on with herbal medicine and other traditional modalities. The revival is happening.

      1. I’m in Pennsylvania. I’m sure there’s some herbal medicine happening here, as it’s happening everywhere, but it’s not very visible. People still look at me like I have two heads if I suggest using plants instead of pharmaceuticals even for simple things like the dandelions. (But buying herbal tea at the grocery store seems to be accepted – I guess as long as it’s packaged in a box and they have to pay for it). And I was picking berries the other day when some guy came up and asked what I was looking for, as if the only reason I’d have my hands on a bush would be if I lost something. I said “berries” and showed him, but he was shocked and said he wouldn’t eat something he found outside. ‘shrug’ I’m so glad to hear New Mexico is on the right path at least!

      2. At 70, with NO health issues, I have been using alternatives, for years. Here, in Kentucky, it is, also going on. Since, I work in a large grocery chain, I get plenty of opportunities to speak about there use.

    2. Insurance may pay for what doesn’t work. Natural help which is cheap may help heal a person fast accept accidents maybe. Gluten/GMO/soy/sugar etc may hurt people and vaccines.

      1. The key word here is “may”. Unfortunately, many people find out after getting major procedures done that their insurance company won’t cover the cost, or just covers a small part of it, leaving them in extreme debt. This even happens in emergency situations where denying the person care would’ve resulted in permanent injury or death. What I was trying to get at was that mandating insurance alone as if that is the key to solving the health care problem is flawed.

        1. Yes…many surgeries are not necessary. EDTA IV chelations may help unclog blood vessels or Vit K2. Cancer and MS maybe helped by gluten free diet. A person today was excited that Mayo Clinic ran many tests for her for every autoimmune issue, but gluten free diet is all she needed. The expensive way to deal with health may only cover symptoms and may not help in the long run. Expensive doesn’t mean it is better/help more. Cheap natural help may restore health in an amazing way.

  3. If you believe that the ultra right wing (Koch bros) Heritage Foundation and its ilk are going to do something for the good of the people you are completely delusional. So sad.

    1. The only way they’d do something benefiting ordinary people is by accident. They only care about themselves. ANH should be more savvy regarding these organizations/individuals because they’d never actually support natural health that takes money away from the powerful.

  4. Alternative medicine prevents health issues and the need for operations/Rehab etc. Rehab may not help since they don’t fix the root cause…usually gluten. Each State forcing their way on people is not good also. Just go back to what it was before. Natural help is cheap and people can learn how to take care of their health so they don’t need to go to the doctor for a cold. Vaccines hurt. 2000mg of fish oil daily stopped my colds/flu for more than 20 years. Alternative medicine can be from a chiropractor who can help with diet/supplements/hair test etc. Schools stopped teaching about the human body/health so people think doctors are god and drugs which only cover symptoms is good. People will fight/raise money for Chemo/MS drugs, but no gluten may prevent cancer/MS and help them heal. $8000 MRI….scams. They can charge anything they want and force you to pay. MRI doesn’t heal the person. Antidepression medicine doesn’t heal the person and may make depression/suicidal thoughts worse due to Fluorine which blocks thyroid. Conventional medicine overcharging needs to stop and they need to do more than cover symptoms, but help the root cause. They keep people sick…withhold what works so they keep the money coming in. Alternative medicine enjoys helping them heal so they don’t need to return and try 100X to get help. Sunlight/eating organic/grounding/exercise/good water/low stress. No gluten/dairy/soy/sugar/GMO/food with a label…taking vitamins/good oils/minerals..probiotic…LDN..detoxing may help brain/body health issues. Accidents can be helped by Conventional medicine. Drugs may have 20 bad side effects and may not help. People may pay for high deductibles/high copayments/high premiums and then go to the doctor and get no help. No gluten may help great and sunlight. Pets/people need no grain so they can thrive.
    Let people get accident coverage and teach them now to help their own health. Letting their health crash/collapse instead of helping them to prevent his is not good. Let them buy insurance that rewards them for learning how to take care of their health. America’s downfall is gluten and now GMO/vaccines/lack of exercise and sunlight etc. They think fake food is food and chemicals are ok. They eat by taste and not for health. Being poor may get people barefoot/sunlight/good food only/own gardens etc…which may help them live a long life. Being rich doesn’t mean you will get better health care if it is drugs etc that only cover symptoms. Insurance may pay for what doesn’t help and may over charge for accidents etc. They wanted to give my son 9 X rays on his hand. He said no and only 3 were taken which was maybe more than needed also. The government can’t afford to be ripped off or people. Educate people about gluten/GMO/vaccines. Ron Paul may have great ideas on how to help or Dr. Mercola. They need to ask a doctor not a politician to write a Health care help.

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