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Kara Jones

Visiting Fellow

Kara Jones serves as Deputy Director of Research and Operations at the American Health Policy Institute, where her research focuses on the impact of health policy on large employers’ ability to provide quality, affordable health care to employees and their dependents.

Jones is also the editor of AmericanHealthCareChoices.org, a robust online destination for credible, substantive news and commentary about pro-consumer, pro-freedom health reform options. She produces a weekly newsletter highlighting the most popular and important articles from the website.

AmericanHealthCareChoices is a project of the Galen Institute, a not-for-profit research organization devoted to advancing ideas and policies that create a vibrant, patient-centered health sector.

Jones graduated from the University of South Carolina and is a Master of Public Health candidate at the George Washington University. She lives in Alexandria, Virginia.

Recent Articles:

Progressive Privilege : Two Truths and a Lie: Employer-sponsored Health Insurance

June 18 2019

Everyone loves the party game "two truths and a lie."

Can you spot the lie about employer-provided health insurance below?

A. Most people with private health insurance get it from their employer.

B. Most people with employer-provided health insurance today have a lot of choice in plans. 

C. Employees can buy insurance on their own and get reimbursed, tax-free, by employers.

  1. True

More than half of Americans with health insurance—180 million people—receive their coverage through an employer. (This is, in part, thanks to the tax exclusion on employer-sponsored health benefits, which subsidizes the employer-based system by excluding health insurance premiums from employees’ taxable income. Those who buy insurance themselves on the individual market do not currently get this generous tax break.)

This statistic may come as a surprise because over the last several years, most of the public discussion around health insurance has focused on the 20 million Americans who have gained coverage under Obamacare. But in fact, most people still get their coverage through work.

  1. Lie

About 80% of those with employer insurance have only one choice of plan. This leaves millions of employees with zero option to choose a health insurance plan that best meets their families’ specific needs.

Additionally, too many small businesses are finding it increasingly difficult to provide any sort of health benefits to their employees due to the rising cost of health care. The number of small firms offering health insurance dropped by 24% between 2012 and 2016.

  1. True!

C is true now, thanks to the recent Health Reimbursement Arrangement (HRA) rule out of the Trump Administration, which will empower employers to give their workers more choice of health plans. (An HRA is an employer-funded account that employees can use to pay for medical expenses and premiums.)

The new rule, set to go into effect on January 1, 2020, gives businesses the ability to give tax-preferred funds to employees so that they can choose their own coverage on the individual market. Roughly 800,000 employers are expected to take this up, benefitting 11 million employees and their family members. Almost 90% of these businesses will have fewer than 20 workers.

This means that employees with a qualifying HRA will now be able to shop around for a private health plan—tax free!—that is best tailored to their health care needs.


Progressive Privilege : New Proposal Aims to Address Rising Out-of-pocket Health Care Costs: Prospect for Bipartisanship?

May 29 2019

Republicans and Democrats have an opportunity to work together to come up with reforms to address the high cost of health care. There are some areas of agreement on this issue. The Senate Health, Education, Labor, and Pensions (HELP) Committee, led by Chairman Lamar Alexander (R-TN) and Ranking Member Patty Murray (D-WA) released a draft discussion last week of nearly three dozen specific proposals to reduce out-of-pocket health care costs and increase health care price transparency.  

The five main parts of the draft bill, the Lower Health Care Costs Act of 2019, include:

  1. Tackle surprise medical billing: The bill would make sure that patients are not held responsible for surprise medical bills received when they see an out-of-network doctor that they didn’t choose. The bill lists three different approaches that health care providers and insurance companies could take to resolve payment for these surprise bills.
  2. Lower the price of prescription drugs: The bill would ensure that pharmaceutical companies don’t game the system to prevent new and lower-cost generic drugs from coming to market. It would also help generic drug and biosimilar companies to speed drug development and avoid patent infringement by providing a searchable patent database. These actions would get lifesaving drugs into the hands of patients more quickly.
  3. Increase transparency in the health care market: The bill would set up a non-profit entity to create an all-payer claims database, which would house anonymous patient health care data that patients, states, and employers could use to better understand their health care costs. The bill would also ban certain anti-competitive hospital contracts, such as those that prevent insurers from sharing pricing information with patients.  
  4. Improve public health: The bill would authorize grants to address important public health issues such as increasing vaccination rates and reducing maternal mortality. It would also give states an evidence-based guide to develop programs to prevent obesity and other chronic health conditions.
  5. Enhance health information technology: The bill would give patients full, electronic access to their own health care claims information and would incentivize health care systems to keep patients’ personal health information private and secure.  

Health care reform is a polarizing issue between Republicans and Democrats, and with current gridlock in Congress, it is not possible for either party to pass its own comprehensive reform. However, rising health care costs continually rank in the top three issues that voters are most concerned about. This presents an opportunity for the two parties to come together and compromise on ways to reduce health care costs for all Americans.

Two areas where we are most likely to see movement in Congress are on surprise billing and prescription drug costs. Large surprise medical bills have become a growing problem for patients who unknowingly visit health care providers that are out-of-network. And as insurance deductibles continue to rise year after year, patients are feeling high prescription drug costs more acutely.

There have been numerous bills introduced to address these two issues, and both Republicans and Democrats agree that patients need relief. The Lower Health Care Costs Act of 2019 would directly address these issues, as well as the others listed above, in its aim to reduce out-of-pocket health care costs.

The Senate HELP committee is requesting input on the draft to be submitted to [email protected] by 5:00pm ET on Wednesday, June 5. The committee plans to hold hearings on the legislation by the end of June and put the bill to a vote later this summer.


 

 


Progressive Privilege : Good for "Proud Capitalist" Democratic Congresswoman Stephanie Murphy

May 8 2019

Congresswoman Stephanie Murphy (D-FL) penned an op-ed last week for the Washington Post titled “I’m a Proud Democrat. I’m Also a Proud Capitalist.” in response to recent media coverage of her comments in which she declared herself a proud capitalist.

Rep. Murphy notes that while the word socialism can mean different things to different people, she describes it as signaling a “disenchantment with and desire to discard the capitalist model that the United States has embraced since its founding.”

Murphy cites her own life experience as the reason why she celebrates the opportunities that a system built on capitalism provides. When she was a baby, her family fled communist-run Vietnam to come to America for a better life. In the states, her parents worked hard to make ends meet and shipped supplies back to relatives in Vietnam, where “the pursuit of socialist economic policies had resulted in shortages and suffering.”

It’s nice to see a Democrat praising free market capitalism, which has led to some of the greatest achievements of poverty alleviation in human history. As Murphy explains, "It’s not easy for me to explain to my Florida constituents who escaped Fidel Castro’s Cuba or Nicolás Maduro’s Venezuela that the socialism proposed by several of my colleagues is different than the socialism they endured."

However, Murphy’s piece downplays the popularity that socialism is gaining within the Democratic party. She writes, "For partisan reasons, [Republicans] seek to paint the entire Democratic Party as drifting toward socialism, when the philosophy is espoused by a small minority of members.” She argues that the Democrats who accept socialism are few and far between.

The data proves otherwise. Pew Research Center’s decades of surveys show that while the Republican center has moved slightly to the right over the past 25 years, the center of the Democratic party has shifted far to the left. Last year, Gallup reported that 57% of Democrats—a majority—had a positive view of socialism, while only 47% had a positive view of capitalism.

Perhaps the Democratic leadership in Congress hasn’t embraced socialism yet, but it sure looks as though their voters are warming to it. In pursuit of a freer and more equitable society, we should heed the words of economist Milton Friedman: “A society that puts equality before freedom will get neither. A society that puts freedom before equality will get a high degree of both.”


Progressive Privilege : What We Learned at the House Hearings on Medicare for All

May 1 2019

"Medicare for All” sounds good until you see its high price tag and consider the implications it would have on the quality and access to health care.  The House Rules Committee held its first ever hearing Tuesday on the Democrats’ Medicare for All bill introduced by Rep. Pramila Jayapal (D-WA). A similar bill was recently reintroduced by Sen. Bernie Sanders (I-VT) in the Senate.

While Medicare for All has little chance of becoming law with Republicans in control of the Senate and the White House, the proposal is quickly gaining traction among 2020 Democratic presidential candidates, earning support from at least seven to date.

As described during the hearing, Medicare for All would implement a government takeover of health care coverage, where all medically necessary services would be paid for by the federal government and all private insurance that duplicates government coverage would be prohibited.  Enrollment in the government-provided coverage would be universal and automatic, and patients would no longer pay any out-of-pocket costs for health care services.

The first of the witnesses to testify in favor of the House bill was patient advocate Ady Barkan, a 32-year-old diagnosed with ALS who contended that Medicare for All would provide high quality health care to all, cut down on administrative waste, and save Americans money.

Grace-Marie Turner, President of the Galen Institute and a witness testifying against the bill, countered that the opponents of Medicare for All have many of these same end goals for our health care system.  “Everyone should be able to get health coverage to access the health care they need, coverage and care should be affordable, we must guard the quality of care . . . and we must work to protect the most vulnerable,” said Turner.

The problem is that a single-payer health care system would move our country away—not toward—these shared goals.  Turner argued that it’s hard to see how patients would be more empowered when dealing with a single government payer for health care: “In a country that values diversity, will one program with one list of benefits and set of rules work for everyone?”

Polls show that while the phrase “Medicare for All” is initially popular, once Americans are told that such a proposal could lead to delays in getting medical treatment, abolish employer-sponsored insurance, eliminate the current Medicare program as we know it, and raise taxes, support drops precipitously.

Dr. Charles Blahous of the Mercatus Center, the second witness testifying against the bill, projects that the net cost of the proposal would reach at least $32.6 trillion in the first ten years.  Another study predicts that 71% of families will pay more under one version of the Senate bill than they would under the status quo.

In addition to the high cost of the program, Medicare for All could also be detrimental to the quality and timeliness of health care that patients receive. The House bill contains a provision that prevents the federal government from paying providers based on quality, which means that poorly-performing doctors get paid the same as doctors who produce good outcomes for their patients.  Additionally, we have seen how patients in Canada and Great Britain suffer long wait times for care under their single-payer systems.

It is evident that many millions of Americans are frustrated with the current health care system. Indeed, health care costs and availability continue to poll at the top of voter concerns. However, we must look for ways to expand access to affordable health coverage that provide more, not fewer choices, to patients.

 


Progressive Privilege : Shocker: New York Times Editorial Finds Something Nice to Say about Trump's Medicare Efficiency Proposals

March 28 2019

The New York Times Editorial Board published a shocking piece this week in support of Medicare efficiency proposals in President Trump’s proposed 2020 budget, calling out unfair attacks by Democrats claiming that these changes would hurt seniors.

Medicare, the national program providing health insurance to American seniors and younger adults with disabilities, is the second largest mandatory spending item after Social Security. The Trump Administration’s budget proposal for 2020 would make prudent changes to reduce Medicare spending by $600 billion over the next decade—without adversely affecting the health care received by Medicare beneficiaries.

The NYT Editorial Board writes:

“…some cuts to Medicare make sense. Several sought by Mr. Trump closely resemble cuts that had been proposed by President Barack Obama. And the indiscriminate attacks by Senate Democrats are a reminder of how hard it has become for Congress to perform even the most basic kinds of prudent housekeeping in the public interest.”

The proposed budget includes practical changes to the Medicare program to make sure that taxpayer dollars are being spent wisely. For example, under the current budget, the government pays higher fees to doctor’s offices that happen to be owned by hospitals for the care they provide to Medicare beneficiaries. This, as the NYT Editorial Board points out, serves “no obvious purpose,” and only drives up federal spending. The largest chunk of the Medicare “cuts” in the Trump budget would come from eliminating these bonus payments to hospital-owned doctor’s offices and making payments site neutral.

The Editorial Board continues:

“But Democrats are not debating the details. Instead, a proposal to improve the efficiency of health care spending is being treated as an attack on the availability of health care. . . . Both parties have fallen into the unfortunate habit of characterizing every proposal to reduce Medicare spending as an attack on the program’s beneficiaries. In fact, careful stewardship of spending is necessary to ensure the program can help as many people as possible.”

In order to ensure the sustainability of Medicare, the federal government will need to take a hard look at cost growth in the program. The program currently comprises 15 percent of the total federal budget and is projected to rise to 18 percent by 2028. Medicare serves about 60 million Americans today, but as more and more Baby Boomers age into the program, that number is expected to rise to 80 million by 2030.

The Trump Administration is right to put forth proposals that get rid of wasteful spending of taxpayer money in Medicare. And the NYT Editorial Board—which is typically averse to praising any conservative proposals—should be applauded for its honest assessment of President Trump’s proposed budget and its effect on American seniors.

 


One News Now : The price of Bernie's plan for health care? Your private plan

May 28 2019

Canada is often pointed to by some Americans as one of the examples they would like a U.S. system to emulate. "But it's important to understand that Canada has one of the most-narrow benefit packages in the industrialized world," says Kara Jones, a visiting fellow at Independent Women's Forum focusing on health policy.

She continues: "When you look at other industrialized nations that provide single payer or universal health care coverage to their citizens, Canada doesn't cover vision and dental care, it doesn't cover out-patient prescriptions, it doesn't cover long-term care or mental health – and these are all some things that Senator Sanders is looking to cover in Medicare of All."

In a related reportThe Associated Press says Medicare for All's rich benefits "leapfrog" other nations. "The real question is 'how are we going to pay for all of this?'" Jones argues.

Sanders offers various ideas on how to pay for Medicare for All. Most, if not all, of the proposals involve a premium or tax of some sort. Meanwhile, the plan would do away with private insurance. Both will be a hard pill to swallow for some consumers, according to Jones.

"180 million Americans get their health insurance through an employer, and this is good, comprehensive coverage that people have already," she notes. "What we need to be doing is looking at how to expand coverage to those who don't already have access to health care insurance."

Jones recalls that it was President Barack Obama who told Americans that if they liked their health plan they could keep their health plan.

"Well, this time around, that definitely would not be the case," she explains, "because those 180 million Americans who have access to private employer coverage … would be dumped into this new Medicare for All plan, this single-payer health insurance plan."


 
 
Independent Women's Forum is an educational 501(c)(3) dedicated to developing and advancing policies that aren’t just well intended, but actually enhance people’s freedom, choices, and opportunities. IWF is the sister organization of the Independent Women’s Voice.​
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