NCPA - National Center for Policy Analysis


January 29, 2010

The problem with Democratic health insurance bills is that they specify what coverage people must buy.  But one size does not fit all well, says Diana Furchtgott-Roth, a contributing editor of Real Clear Markets and an Adjunct Fellow at the Manhattan Institute. 

Rep. Paul Ryan (R-Wis.) has an idea to fix health reform.  In his "Road Map for America's Future," reintroduced this month: 

  • Americans would take refundable tax credits -- $2,300 for singles and $5,700 for families -- and choose private insurance.
  • All insurance plans that are licensed in a particular state would be eligible, and each company would be free to set its own premiums.
  • Low-income individuals would get extra tax credits so they could buy the same kind of health care as other Americans. 

What about Medicare? 

  • Medicare would remain the same for current beneficiaries and for those 55 and older when they reach 65.
  • But when those born in 1955 or later become eligible for Medicare at age 65, their plan would change.
  • They would receive $11,000, adjusted for inflation, to buy a Medicare certified plan.
  • Those with lower incomes or with more serious health conditions would receive more funding. 


  • Health insurance companies could offer high-deductible plans carrying lower premiums combined with health savings accounts, or more traditional managed care or fee-for-service plans.
  • Persons with high-cost chronic illnesses, such as hemophilia or diabetes, would be placed in special affordable state high risk pools, with subventions paid by the government. 

On Wednesday, Congressional Budget Office Director Douglas Elmendorf wrote to Ryan to tell him that this plan reduced health care costs and the federal deficit.  He said: "Under the proposal, national health expenditures would almost certainly be lower than they would under the alternative fiscal scenario.  Federal spending for health care would be substantially lower, relative to the amount in that scenario, for working-age people and the Medicare population." 

Source: Diana Furchtgott-Roth, "A New Approach to Health Reform," Real Clear Markets, January 28, 2010. 

For text: 


Browse more articles on Health Issues