Analysis of Senator Ted Cruz’s “Health Choice Act of 2015″

I have now read through Senator Ted Cruz​’s entire new “Health Choice Act of 2015“. Here’s what it accomplishes in a nutshell:

1.) It repeals Title 1 of the Patient Protection & Affordable Care Act a.k.a “Obamacare” and all it’s amendments, including those amendments put forth via the law’s companion. Namely  the Health Care and Education Reconciliation Act of 2010.

Title 1 of the PPACA contains:

A. ) The onerous “pay or play” mandates on individuals and employers a.k.a the unconstitutional ‘fine’ (TAX) for not buying health insurance.

B.) The health insurance “exchanges”.

C.) The federally mandated policy design changes forced upon every health insurer i.e. the ‘Ten Essential Benefits‘ including maternity, 63 ‘free’ preventive care tests and exams, abortifacient drugs etc.

As I have proven before, the vast majority of health insurance plans that existed before the PPACA – that were subsequently canceled because of the PPACA – contained most of the PPACA required “Ten Essential Benefits” already. As such, they did not need to be canceled in order to provide adequate coverage.

D.) The onerous MLR – Medical Loss Ratio – requirements that have forced 13 health insurance carriers out of the market.

E.) The ‘Failure To Launch’ clause a.k.a. ‘keeping your child on you plan until age 26‘ whether they are married, unmarried, attending college or dependent on their parents financially.

Most states required carriers to keep your child on your plan until age 25 or longer,long before Obamacare. Contrary to popular belief, many states did not require these young adults to be attending college. However,  unlike the PPACA requirement, you had to be single (unmarried).

F.) Eliminates annual and lifetime maximums of coverage.

Annual coverage maximums should continue to be barred as well as lifetime caps. Lifetime caps are so rarely exceeded that this is nearly a moot point. Annual maximums should never have been allowed in the first place.

G.) The prohibition on preexisting conditions in the individual health insurance marketplace.

Cruz relies upon existing protections outlined in section 2741 and 2744 of 1996 HIPPA law for those with preexisting conditions in the individual market who are HIPAA qualified. This means that they have maintained existing coverage for at least 18 months with no lapse in coverage of more than 63 days. These insured members would have guaranteed access to coverage for preexisting conditions in the individual market via:

A). A state high risk health insurance pool – which existed in 35 states long before the PPACA
B.) A guarantee issue individual mandate – which existed in 10 states long before the PPACA
C.) A state mandated replacement policy – which is required to be offered in the states that did not have one of the two aforementioned options under section 2744 of HIPAA.

All of these existing protections against preexisting condition clauses were in existence for years before the PPACA. As I have proven before the Democrat’s argument pertaining to preexisting conditions has been inaccurate, disingenuous and in the case of President Obama a proven and repetitive lie.

H.) The Advance Premium Tax Credits and Cost Sharing Reduction federal subsidies allotted to those who fall below certain income levels and purchase their coverage “on the exchange” via

Other Republican proposals such as Avik Roy’s “Transcending Obamacare” plan suggest keeping the exchanges and lowering the eligibility to receive the aforementioned federal subsidies from 400% above FPL to 317% above FPL. Still other plans such as the “Patient Care Act” proposed by Senator Burr, Hatch and Upton would replace the PPACA with a means-tested tax credit that individuals could use to buy a far broader range of insurance products, or deposit the funds in a health savings account. Other Republicans have proposed keeping PPACA subsidies in place for a ‘transitional period’ should the rule of law prevail in the pending King v. Burwell case, currently being heard by the U.S. Supreme Court.

2.) Cruz’s plan also provides a viable and well regulated solution to selling health insurance across states lines.

Whilst Cruz’s plan is a very good start to providing real alternative reforms of the individual health insurance market. It does not attack the primary drivers of cost. Namely, cost shifting from preexisting federal health care programs like Medicare and Medicaid and the prohibition of competing hospitals and surgical centers promulgated for far too many years by the Federal Trade Commission. It also does not address the massive and fiscally unsustainable expansion of Medicaid under the PPACA nor does it provide a plan for the preservation of Medicare. All of those issues and more are addressed in Avik Roy’s “Transcending Obamacare“. To be fair, Senator Cruz plans on revealing a far more comprehensive plan in the coming months. I am waiting to read it with great anticipation.

One thing remains true, unlike the lies from our ‘friends on the Left’. Republicans have no shortage of Obamacare replacement plans. More than 25 have been proposed. What we do need to do is coalesce around one of them and promote it nationally and consistently starting yesterday.


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2 responses to “Analysis of Senator Ted Cruz’s “Health Choice Act of 2015″

  1. Deb Pattin

    F) Lifetime cap: My niece, who has Chron’s disease, exceeded her lifetime cap with Kaiser when she was hospitalized for 88 consecutive days in a nearly fatal Chron’s attack. If the Affordable Health Care Act had not been in effect, she would now be dead, rather than preparing on March 10 to graduate from the University of Washington with a degree in Global Medicine.

    • The vast majority of policies provided between $5 and $8 million lifetime per insured member long before the PPACA Deb. That said, since such occurrences are extremely rare I’m for waiving lifetime caps completely.

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