REFORM STEPS FOR TEXAS
February 8, 2007
Texas needs to end its addiction to inefficient, unresponsive public policies. To that end, the Legislature should go cold turkey and consider radical changes, says the National Center for Policy Analysis (NCPA).
- Texas should ask for a block grant for Medicaid with no strings attached; then, it should empower enrollees to become prudent shoppers in a competitive medical marketplace.
- Texas needs tighter rules, financial incentives for seniors to choose community care over nursing homes, and home care over community care and the option (already available in four other states) to buy long-term care insurance that both pays for care and protects estates under Medicaid rules.
- Texas should implement an NCPA/Blue Cross proposal to replace the dysfunctional small group market with a system in which employees own their own insurance and it travels with them from job to job; employers would make defined-contribution premium payments, similar to 401(k) plan contributions.
- In Massachusetts, Gov. Mitt Romney used free care money to subsidize private insurance; Texas should follow his example, with modifications: no individual mandate, no additional spending and no special-interest mandates.
- Elected officials need to find out how much state and local governments have promised employees in health and pension benefits after they retire and start funding obligations that need to be honored; at the same time, state employees need new options like Health Savings Accounts and Roth 401(k) accounts, so they can have tax-free income during their retirement years.
Texas is one of the freest states in which to work and do business mainly because the state government has refrained from unwise actions. More can be done. Government institutions that are not working should be reformed. Texas needs to lead, not follow, says the NCPA.
Source: "Twelve Reform Steps for Texas," National Center for Policy Analysis, Brief Analysis No. 580, February 8, 2007.
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