President Joe Biden has fulfilled his promise of ensuring Americans have near-universal access to health insurance. But this high level of coverage has been accompanied by a skyrocketing cost of care, leaving needed medical care out of reach for many and our country’s economic future in peril.
Americans spent $4.5 trillion on medical costs in 2022, nearly doubling from 2009 when Biden, then vice president, assured Americans that healthcare would become more affordable once government-run marketplaces became the norm.
The record-breaking year of 2022 was just the tip of the iceberg. Employer-provided healthcare costs are projected to grow by nearly 10% in 2024, the single largest hike in a generation, leaving employment in peril for many. Nevertheless, Biden has committed to maintaining the third-party system that ignores the individual needs of families even as it threatens their health.
Insurance coverage may have risen, but millions of Americans still choose to delay care because of healthcare inflation. A March study from GlobalData asked healthcare providers around the globe how inflation was impacting patient behavior and care. The results showed that, in the United States, 71% of healthcare providers reported patient postponements, 68% of which expected two or more years to resolve the problem. Another study in Massachusetts found that 40% of people put off medical care due to cost. Yet another report found that even workplace-insured people are delaying care due to costs, creating lifestyles of pain, uncertainty, and reduced work productivity.
Lower-income individuals and families need more than just the empty rhetoric of “affordable care” to fulfill their healthcare needs. Under the Affordable Care Act, Americans must look to third parties for medical necessities, a system that benefits insurers at the expense of families and individuals.
Rather than enrich third parties, lawmakers should embrace the personal option, which would put patients at the center of healthcare.
There is already legislation before Congress that would do just that. The Affordable Care and Comprehensive Economic Support through Savings Act (H.R. 5608) accomplishes this goal by increasing access to Health Savings Accounts for nearly 5 million lower-income families.
Introduced by Reps. Greg Steube (R-FL) and Kat Cammack (R-FL), the ACCESS Act would reform the IRS code to allow those enrolled in high-deductible healthcare plans to reallocate pre-taxed, cost-sharing funds under the ACA into a tax-advantaged HSA.
This money would belong to the enrollee — not the government or its preferred insurance companies. The patients would decide how to spend their healthcare dollars best. If an individual wants to see a trusted doctor who happens to be outside their provider network, an HSA would allow him or her to do so without incurring prohibitive costs.
In placing the individual, and by extension, the family, at the center of healthcare, the ACCESS Act provides a needed choice. Instead of delaying care, families can use their hard-earned HSA funds to receive the care they need.
The HSA proposal of the ACCESS Act is completely voluntary. Like your ACA plan? Keep it, but allow those cowed by costs to have control and choice. H.R. 5608 simply offers another, more personal option to those who need it.
Not only would the ACCESS Act benefit its users, it would save an estimated $30 billion dollars in government healthcare costs over the next decade, as calculated by the Congressional Budget Office. This means more savings, fewer wasted taxpayer dollars, and a solution to rising healthcare inflation.
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But rather than expanding patient control over care, the Biden administration is continuing to hold tight to the pricey model of coverage, with costs hidden behind the thin veneer of tax credits. A tax credit at the end of the year will mean little to people putting off the doctor for fear of overpriced medical bills, which have increased year after year.
Even if Biden increases insurance coverage to 100%, Americans must ask themselves if this is something to celebrate. Doubling down on the ACA model of coverage means we will continue to shell out ever-growing piles of money for a card that does not assure care. It is time to stop rewarding insurers and instead look out for patients hungry for more choice and control.
Marion Mass, M.D. is a practicing pediatrician, co-founder of Practicing Physicians of America , and leader for Free2Care.