Family medicine

The researches find that the pronouncements lies a conundrum: whether to stray beyond efforts underway to improve the nation’s health care system loosening insurance regulations, talking about drug prices, expanding tax-free health savings accounts to develop an overarching plan. For the White House, it’s a fraught decision. A comprehensive plan could be a lightning rod for opponents. Conversely; not having a plan for replacing some of the most popular parts of Obamacare ; such as its coverage protections for people with preexisting medical conditions could leave the GOP flat-footed if an administration-supported lawsuit before the 5th Circuit Court of Appeals invalidates the sweeping health law.

Nation’s health care system

“This is a real conundrum. There is a risk with action or inaction,” said Dean Rosen, a Washington, D.C., health policy consultant who often advises Republicans. No matter how the 5th Circuit rules, its decision; which could come soon, is likely to be stay while the issue heads to the Supreme Court. Such a delay would give the administration time to flesh out a proposal if the appeals judges throw out the ACA; but it would also ensure that a health care debate is front and center during the presidential campaign.

Right now, polls show the public is focused on health costs; said professor Robert Blendon, who directs the Harvard Opinion Research Program, which studies public knowledge of health care and policy issues. Consumers are concerned about what they pay at the pharmacy counter or the sum of their insurance premiums and deductibles. “Most voters are not interested in another debate on a new health plan,” he said. But if the 5th Circuit upholds a Texas ruling overturning the entire ACA; “that changes the entire framework,” said Blendon. “The administration could not just say, ‘Oh, we’ll have something great.’ They would have to have something outlined.”

Focused on health costs

Supporters and critics say likely elements are already in plain sight; both in executive actions and proposals in the president’s budget as well as a little-noticed white paper released late last year. The president has won praise from both conservatives and liberals for such things as his proposals to require hospitals to post their actual; negotiated prices; and some strategies to lower drug prices. But legal battles within the health industry could thwart such initiatives.

On these topics, “a lot of what they’ve proposed has been pretty smart;” said Shawn Gremminger, senior director of federal relations at the liberal Families USA advocacy group. Still; Gremminger points to other administration actions  loosening rules on health insurers to allow sales of what critics call “junk” insurance because they don’t have all the consumer protections of ACA policies; or promoting work requirements for Medicaid recipients  as strong hints to what might be in any eventual election-related plan.