Lexington reforms: Lower costs, better care for city, workers

Health-care reform gave many Kentuckians affordable access to health care for the first time in their lives. Making health care more affordable and accessible for all families and businesses is a top priority. Many Americans who get insurance through the individual marketplace have seen their health-care costs increase, while others, especially those with employer-provided insurance, have fared better under the new law.

The Affordable Care Act is a massive, complex piece of legislation that has permanently altered the health-care landscape in America. This is a difficult problem that can’t be solved with sound bytes and talking points. I am committed to working with Republicans and Democrats to find practical solutions and hold down costs.

I learned about health-care reform as mayor of Lexington. We reformed our own plan. We did it by increasing plan options — for the first time offering lower premium, higher deductible plan choices coupled with an employer funded Health Savings Account. The majority of our employees and their dependents chose to go with this option.

We also invested in a clinic and our own pharmacy, helping break down the cost barriers to care and redirecting the focus of care to prevention, disease management and providing affordable prescriptions for our employees and their families. All these efforts combined saved a tremendous amount of money for both the city and employees, and improved the health of many.

Importantly, we planned to keep costs low year over year. And it worked. While most premiums regionally and across the country have exploded in terms of expense, our premiums have been well below average for four years without reducing benefits.

There are creative and proven ways to improve health and reduce the cost of health care. Most politicians don’t know enough about the problem to be helpful in implementing solutions. Some just complain and say we’ve got to start all over. Rand Paul is one of those politicians. To make a real difference we have to insert the people who know the business the best and intentionally work on meaningful changes.

We need to add more affordable options to the health-care exchange and expand consumer choice. We know everyone does not want or need an expensive platinum plan. Sen. Mark Begich introduced the Expanded Consumer Choice Act (S. 1729) which would create a new tier of coverage, available through the marketplaces, with a lower actuarial value and higher threshold for out-of-pocket costs. Options like this could lower health-care costs for many consumers.

I’m for repealing the Cadillac Tax that will be applied to high-value health plans starting in 2020 because we shouldn’t make health care even more expensive with large excise taxes. I’m also for repealing the medical device tax, because it stifles innovation and limits job growth.

We’ve got to ask the question, how do we help small businesses and boost the investments we’re making in those companies that are providing their employees health insurance? Several senators have supported a number of ACA fixes, including an expansion of the health-care tax credits for small businesses. They supported expanding tax credits to include businesses with fewer than 50 employees — instead of the current cap at 25 employees.

On the other side of this issue is Paul, a doctor who’s for throwing the baby out with the bath water and going back to the time when the insurance companies called the shots. That’s bad policy and an insult to the 20 million nationwide, including 355,000 Kentuckians, who have gained health insurance since implementation of the ACA.

Repealing the Affordable Care Act is not an option. Fixing it is.

This story was originally published October 22, 2016 at 6:27 PM with the headline "Lexington reforms: Lower costs, better care for city, workers."