Chip Coldiron: A Plan to Fix and Heal Our Broken Healthcare System

I know the failings of our healthcare system firsthand – both from my experience in the industry working in patient care, and as a father of a child with a pre-existing condition. When the out- of-pocket costs for my son’s annual EKG skyrocketed, my family was fortunate enough to manage those expenses. But I know that far too many Hoosiers are not so lucky. Fixing our broken healthcare system is the issue that got me into this race, and that is why I am proposing my” Fix and Heal Plan as the first policy proposal in my campaign for the U.S. House of Representatives.

For years, politicians in Washington have been promising to address rising health costs and coverage gaps. When the Affordable Care Act (ACA) passed in March 2010, it marked a momentous step forward to making our healthcare system more effective for working people. But between flaws in the original legislation, a decade of attacks by politicians and special interests opposed to progress, and systemic inequities that prevent access to far too many, we need a new plan to finally deliver on the promise of better health care for all.

In the midst of the COVID-19 pandemic, the need to address the failings of our healthcare system and ensure every American has affordable and quality care has only grown more urgent.

Healthcare is a right. And if elected your Congressman for Northeast Indiana, I will make fixing our broken healthcare system my top priority. I promise that addressing the problem will be my first act in Congress. In my “Fix and Heal” Plan, I outline the key elements of what that plan will look like, and how we can undo the attacks on the original ACA, and fix the shortcomings of the Affordable Care Act to deliver universal coverage, affordable care, quality service, and equitable access.

My Fix and Heal Plan will:

1. Institute a Public Option Administered through Medicare and allow Medicaid enrollees and those eligible for Medicaid expansion to choose the Public Option at no premium cost.
2. Establish a “Universal Coverage Guarantee” that automatically enrolls those without insurance in the Public Option after 1 year, unless an opt-out option is chosen.
3. Eliminate “Skinny” healthcare plans that are intended to work around the ACArequirements and leave enrollees without adequate coverage.
4. Lengthening the enrollment period from 45 days to 120 days annually, create an initial1-year open enrollment period for the first year after the Public Option becomes available, and increase funding for the advertisement of the ACA marketplace and the navigator program.
5. Re-institute cost-sharing reduction payments (CSRs).
6. Eliminate Medicaid work requirements.
7. Re-evaluate Essential Health Benefits to strengthen protections for contraceptioncoverage, mental health and substance abuse coverage, and long-term care.
8. Expand access to community health centers and rural health clinics.

Section 1: Institute a Public Option Administered through Medicare and allow Medicaid enrollees and those eligible for Medicaid expansion to choose the Public Option at no premium cost.

Every other industrialized nation in the world has some form of health insurance or health care services, at least partially, provided as a public good, and the Medicare program has been a wildly successful, popular, and efficient public program that has helped to ensure our seniors get the care they need and paid for over the course of their entire lives. For too many Americans, the private health insurance market has proved to be a burdensome, expensive marketplace plagued by large overhead costs and complex coverage schemes. Only when the Affordable Care Act was instituted did the industry begin to be reigned in. Now it is time to expand on those efforts to ensure every American has access to high-quality, affordable care.

My “Fix and Heal” Plan will address this gap by instituting a Public Option administered by Medicare that will allow anyone unsatisfied with their private insurance through the exchange or their employer, and anyone without insurance, the ability to join those already covered by Medicare with a similar plan. Payments will be scaled to income based on the premium caps already used under the Affordable Care Act, and administered as a tax. Additionally, those eligible for Medicaid, or for Medicaid expansion in states that have not chosen to expand Medicaid, will have the choice to join the Public Option at no premium cost, and expand the consumer base.

My plan will increase competition for the private market, increase options for all Americans, and provide a large base of insured who will have negotiating power to reduce costs.

Section 2: Establish a “Universal Coverage Guarantee” that automatically enrolls thosewithout insurance in the Public Option after 1 year, unless an opt-out option is chosen.

Rather than the burdensome and heavy-handed individual mandate, my “Fix and Heal” Plan will reach universal coverage by automatically enrolling anyone without insurance in the Public Option 1 year after passage, unless an opt-out is chosen. This Universal Coverage Guarantee will also apply to all newborns going forward unless their parents opt to insure them through other plans. Opt-out options will include choosing private coverage through employers or other groups, or on the individual exchange.

Universal coverage is important not only to ensure every American can receive the care they need when they need it, but to also ensuring that the costs borne by those receiving care without coverage is not passed onto other patients. It is essential for keeping costs low that the coverage pool for health insurance includes everyone—including the young and healthy. Butthis goal should not come at the expense of people’s financial health.

My Universal Coverage Guarantee and automatic enrollment achieves the same outcome for the industry as the individual mandate, but streamlines the process, takes the stress and burden off of the American people, and ensures no American is left behind. Because payments for the Public Option will be tailored to income, no American will need to worry about enrolling in a plan that they cannot afford.

Section 3: Eliminate “Skinny” healthcare plans that are intended to work around the ACArequirements and leave enrollees without adequate coverage.

I understand that coverage and affordability is only part of the equation in fixing our healthsystem. While we must ensure everyone is covered with a plan that doesn’t break the bank, wemust also ensure that coverage provides high-quality care.

“Skinny” insurance packages have often been used to get around the coverage requirements of the ACA, and consumers have been drawn toward them by financial need. These plans often leave essential services uncovered, and when something goes wrong, enrollees are left with high costs and little option for getting the care they need.

With affordability addressed through the Public Option and other reforms, my “Fix and Heal”Plan would also eliminate the use of “Skinny” insurance plans and enforce minimum coverageplans across the industry.

Section 4: Expand the enrollment period from 45 days to 120 days annually, create an initial 1-year open enrollment period for the first year after the Public Option becomes available, restore funding for the advertisement of the ACA marketplace, and scale up the navigator program.

Choice is an essential aspect of American economic life, and when it comes to how individuals and families care for their health needs should be no exception. Consumer choice is essential to creating healthy competition in the marketplace, and with an issue as complex as healthcare, we need to be intentional about providing ample time for everyone to make sure every American can make informed choices. While open enrollment periods provide an incentive for healthy people to sign up for coverage, artificially limiting that window only inhibits choice.

Expanding open enrollment period to 120 days will provide an adequate time frame for individuals and families to explore all their options and make the choice that works best for them. Additionally, under my plan, this expansion will be supplemented by a 1-year period where all Americans will be able to enroll in the newly available Public Option to ensure everyone is able to take the time they need to assess the new plan in comparison to their existing insurance.

Finally, my plan will also restore funding for advertising and public engagement related to the ACA marketplaces and the public option, as well as scaling up the navigator program so every American has the information they need to make their decision.

Section 5: Re-institute cost-sharing reduction payments (CSRs).

Re-instituting cost-sharing reduction payments, or CSRs, is essential for ensuring the individual insurance market remains effective for low- and moderate-income people. Originally, the CSR payments were used to provide additional discounts for low- and moderate-income peopleseeking a “silver” level plan on the exchange. When CSRs were removed under the Trump

Administration, insurance companies passed these prices onto consumers and priced far toomany out of ACA’s individual exchange. While ending these payments were pitched as anattempt to save taxpayer money, courts have held that insurance companies are still entitled tothat money. Chip’s plan would reinstate those payments, and ensure if the government is going to be paying the money anyway, then consumers should be able to benefit.

Section 6: Eliminate Medicaid work requirements.

Under my “Fix and Heal” plan, I would eliminate Medicaid work requirements that represent an unnecessary bureaucratic complication to a program intended to help our most vulnerable populations.

Medicaid work requirements are an ineffective and overly burdensome regulation that only makes our system more complex and shuts those eligible for care out of an essential program. Our entire health system works better when everyone can access care because more people are able to utilize preventative care, and fewer emergency costs are passed onto consumerswho already have insurance. It is in everyone’s interest to ensure the entire population is covered, and since Medicaid already has income or disability requirements that limit eligibility, adding yet another regulatory burden on top of it only adds to the cost without significant benefit to taxpayers.

Section 7: Re-evaluate Essential Health Benefits to strengthen protections for contraception coverage, mental health and substance abuse coverage, and long-term care.

I believe there are some things that every plan should cover without co-payments and deductibles, no matter where you receive your coverage. Under the Obama Administration, the Affordable Care Act sought to address these needs through the Essential Health Benefits, but over the past decade, Congress, the Trump Administration, and special interests have worked to undermine these protections as a boon to the private health insurance industry. Under my “Fix and Heal” plan, Congress would require the Department of Health and Human Services to expand their set of Essential Health Benefits to strengthen their protections and would placespecial focus on strengthening benefits for contraception coverage and women’s health, mentalhealth and substance abuse coverage (including mediation-assisted treatment), and long-term care (including portable benefits that can be used in-home or at a long-term care facility).

Section 8: Expand access to community health centers and rural health clinics.

Fixing our healthcare system not only requires universal coverage, but also physical access to the health care services people need to stay healthy. I know how important local access to health services is, and I understand that our health infrastructure does not reach all communities equally—especially communities of color and low-income, rural communities.

That is why my “Fix and Health” Plan also includes increased funding for community health centers and rural health clinics. Under his plan, Congress would authorize the funding to double the number facilities across the country, and direct the Department of Health and Human

Services and other Federal agencies to identify communities with the highest need for the placement of new facilities.

Summary

No one should have to choose between their physical health and their financial health. I am a public school teacher, a veteran of the United States Army, and a former healthcare worker, running for Congress to make sure every Hoosier in Northeast Indiana has a voice they can trust in Washington.

My “Fix and Heal” plan to address our broken healthcare system not only represents my priorities for how to serve the real needs of Hoosiers in the Third District, but also represents anopportunity for the constituents of Indiana’s Third District to engage with me in a conversationabout what they need from their leaders in Washington. I have heard from voters all over theregion about what they need and what they haven’t received from their leaders, and thoseconcerns are clear. Working Hoosiers need:

1. 1)  Affordable, quality care they can count on.
2. 2)  Health Insurance they understand and can navigate.
3. 3)  A government that works for them, not special interests that fund our opponent’scampaign.
4. 4)  Access to the physical services they need in their community.

My priorities are to address these needs, and the “Fix and Heal” Plan is a starting point to moveus forward. I understand this issue is complex, won’t be solved overnight, and that someHoosier may disagree on the specifics. But what I can promise is that those concerns will always be heard when I am in Congress. As your Congressman, I will always continually work to be responsive to the developing needs for the health and well-being of Hoosier families, workers, and communities in Northeast Indiana.