Kathmandu— The Searchlight Institute, a centrist think tank, has released a health care policy proposal aimed at making primary care services free and introducing a new public insurance option. However, the initiative faces criticism for its limited impact and internal contradictions, particularly in addressing uninsurance and administrative inefficiencies.

Free Primary Care Proposal

The Searchlight proposal includes making primary care services free for all patients by adding it as an eleventh essential health benefit under the Affordable Care Act. However, this change would only affect a small portion of out-of-pocket spending—between 0.6% and 1.8% of total health expenditures. Critics argue that while this initiative may seem significant, its actual impact is minimal and could lead to higher premiums for households.

Public Option Proposal

The proposal also introduces the American Health Gateway, a public option intended to compete in both ACA exchanges and Medicare Advantage markets. However, it excludes employer-based insurance plans and Medicaid Managed Care Organizations (MCOs), raising questions about its comprehensiveness. Critics point out that this approach is overly complex and fails to address existing issues within private insurers operating in the Medicare Advantage market.

Selective Subsidy Restoration

Searchlight proposes restoring higher exchange subsidies introduced during the Biden administration but only for individuals in states that have expanded Medicaid. This selective approach excludes a significant portion of those who would benefit, leading to criticism over its fairness and effectiveness. Critics argue that punishing individual enrollees for their state's lack of expansion is unjust.

Loved Ones on Health Plans

The proposal allows individuals to add 'loved ones' to health plans, regardless of family ties. While this could provide flexibility, it also raises concerns about potential abuse and the need for clear guidelines to prevent misuse. Critics argue that without strict definitions, this provision may lead to unintended consequences.

(With inputs from Jacobin)

Originally published on abcnews.com.np.