Op-Ed: Brat & Spanberger Pursue Opposite Approaches to “Competition” in Healthcare

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By Susan Ahern

Dave Brat in Virginia’s 7th District, and other Republicans, have called on Trump to lessen “burdensome regulations,” and make “it possible for people to once again buy the low-premium coverage they prefer.” (Dave Brat, “We Still Can’t Get Healthcare Right,” March 27, 2017).

President Trump responded by recently expanding “short-term,” inexpensive health plans, known as “skimpy” policies. They became available on the ACA Exchanges in October.

As Dave Brat has called for– these “skimpy” policies increase competition, lessen regulation, but they also gut consumer protections. “Skimpy” plans don’t have to cover pre-existing conditions, or cover 10 Essential Benefits on the ACA– such as ER care, prescription-drugs, mental-health/ substance-abuse counseling, cancer treatments, etc. Some doctors call these “skimpy” policies “junk insurance.”

The Trump administration says “skimpy” plans are good for young/ healthy people. However, young people who get critically injured in car accidents, have substance-abuse issues, acquire youth cancers (testicular cancer, or leukemia), might be left high and dry on “skimpy” plans.

Also, economists warn if younger/healthier people pull out of the ACA– premiums may skyrocket for sick and older folks left on Exchanges. And buyers beware: ‘Skimpy” plans historically have been falsely marketed–promising to cover conditions that in the fine print (few read) are not actually covered.

Dave Brat is also advancing high-deductible Health Savings Accounts (HSAs) to add competition in the healthcare marketplace. These accounts, often invested in the stock market, allow consumers to save for medical care tax free. People who rarely get sick/ injured make out best with HSAs.

Brat’s biggest contribution to healthcare is that he co-sponsored a bill raising dollar limits people can contribute to HSAs each year– up to $9,000 for individuals and $18,000 for families.  The higher your earnings, the higher your tax deduction with HSAs, so these accounts clearly favor wealthier consumers.

Abagail Spanberger, also running for congress in the 7th District, wants to increase competition in health care, too. Spanberger wants to maintain coverage of the 10 Essential Benefits in the ACA for all Americans, as well as protections for pre-exiting conditions. She also believes Medicare X (which is not universal health care) would compete on Exchanges with private insurers, encouraging them to lower overhead and thus premiums.

Medicare X would be a public option on ACA Exchanges, which consumers could voluntarily buy at any age. This plan uses the same doctor networks in traditional Medicare (the popular seniors government healthcare plan) but would also cover maternity/pediatrics.

Importantly, Medicare X would not touch the Medicare Trust Fund, or change its solvency, because consumers would pay premiums. But Medicare X would be affordable, because unlike private insurers, it doesn’t have high overhead. That’s because it doesn’t have to pay shareholder profits/ big CEO bonuses, or spring for expensive TV ads/ fancy PR.

Importantly, Medicare X would be rolled out in rural areas first, since rural areas have little competition on the Exchanges and many rural hospitals are struggling to survive.

Knowing how candidates define “competition” in healthcare helps constituents be more educated voters.


Susan has written Op-Eds for the Richmond Times Dispatch, the Washington Post, San Francisco Chronicle, Style Weekly, among other publications. She has a MS in Journalism from Kansas University. She is a guest writer for R2D.

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3 thoughts on “Op-Ed: Brat & Spanberger Pursue Opposite Approaches to “Competition” in Healthcare

  • November 1, 2018 at 6:27 am

    Medicare X makes perfect sense. Brat pretends to want affordable health care for all but his “solutions” say otherwise.

  • November 1, 2018 at 7:29 am

    Spanberger’s approach, for a public option, to be rolled out in rural areas first, makes perfect sense!!

  • November 1, 2018 at 9:46 am

    My biggest fear has been the Republicans overturning the ACA. My husband and I both in our early 60s, have pre-existing conditions. Despite Dave Brat’s desperate revisionist history of his voting record, he has voted numerous times to remove the protections of pre-existing conditions or allow insurance companies to charge many multiples of the current rate, essentially making it unaffordable. Because I was on the exchange, I was able to get life saving heart surgery I needed two years ago. We fully pay for our insurance as we are not eligible for subsidies. With the Dave Brat plan, we could not afford rates up to eight times the current premiums. Dave Brat says: pay all your medical bills through a health savings account! What rubbish! How many people have an additional $18,000 to throw into this? Just more tax breaks do the wealthy for Dave! How many people with pre-existing conditions would spend that easily in a year? No Dave!
    Thank goodness for Abigail Spanberger’s support for Medicare X. We could buy it on the exchange and have the same benefits and services most older adults and disabled people have. Most doctors accept Medicare. This is not “universal healthcare” (even though I would support that), this is a smart step in order to get everyone covered who either doesn’t have an exchange choice, or doesn’t like that choice.
    This November, the choice is clear: you can vote for Dave Brat who has voted many times to just repeal health care entirely, and then lies about it, or if you are like the 53% of people using the ACAv exchanges who love Obamacare, you can vote for Abigail Spanberger to protect health care through the initiation of Medicare X.


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