James C. Capretta is a resident fellow and holds the Milton Friedman chair at the American Enterprise Institute.
He studies and provides commentary on a wide range of public policy and economic issues, with a focus on health-care and entitlement reform, and U.S. fiscal policy.
Mr. Capretta served for nearly sixteen years in senior positions in the executive and legislative branches of the federal government. From 2001 to 2004, he served as an Associate Director at the White House Office of Management and Budget (OMB), where he had responsibility for Medicare, Medicaid, Social Security, education, and welfare programs. Earlier, he spent a decade at the Senate Budget Committee as a senior analyst for health care and entitlement policy.
Mr. Capretta’s articles and essays have appeared in a large number of print and online publications.
Recent Posts by James Capretta
Yesterday, Senate Republican leaders released their version of health-care legislation. The bill is best understood as a GOP amendment to the Affordable Care Act. In 2009, if the Republicans had attempted to modify rather than defeat the ACA, this is the kind of amendment they might have offered.
A compromise plan would combine a middle-ground expansion of the program with financing reforms that lower costs over the longer term without imposing undue risks to beneficiaries or the states.
The private sector has the ability to move quickly to test new approaches because it faces fewer political constraints than the federal government. However, employers as a whole have not maximized their role due to current federal policies and overall risk-aversion.
Building an automatic enrollment system will be complex and will require the cooperation of state governments, providers of medical services, and insurers, if it is to be successful.
There is bipartisan agreement on the goal of promoting more efficient and effective health care. The debate is over the best way to accomplish the goal, not the goal itself.
CBO is basically correct that AHCA would trigger a short-run rise in premiums and both short- and longer-term increases in the number of uninsured people. Instead of trying to discredit these findings, AHCA’s authors would be better off using CBO’s estimate as a guide for fixing the bill.
The ACA repeal and replace plan, dubbed the American Health Care Act, has the major components needed for effective health reform. However, the plan falls short on several crucial details, details that can and should be changed before the bill clears Congress and goes to the president to become law.
The most likely end result of “repeal and delay” would be less secure insurance for many Americans, procrastination by political leaders, and ultimately no discernible movement toward a real marketplace for either insurance or medical services.
The main problem with the exchanges is not with the exchanges themselves, but with Affordable Care Act policies that have undermined the ongoing viability of the entire individual insurance market.