Sen. Rick Scott pushes HSA plan as Obamacare subsidies near expiration

Sen. Rick Scott pitches Health Savings Account plan

Republicans, including President Trump, have promised for more than a decade to improve Obamacare. Evan Axelbank reports.

TAMPA - Republicans, including President Trump, have promised for more than a decade to improve Obamacare.

The backstory:

Sen. Rick Scott says the answer is to send money straight to those who need it, in the form of health savings accounts.

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Scott is spearheading the Republican effort to find their own signature health care plan.

"It's really important to me because I watched my family not have it," Scott said.

Big picture view:

Scott is urging GOP senators to sign on to a plan that would scrap Obamacare subsidies — for some — and give Americans a stipend to stash in a health savings account to use either for doctor's visits, catastrophic insurance or for co-payments and deductibles.

Scott is also insisting that doctors and hospitals be forced to post their prices.

"You shouldn't be surprised about anything in healthcare," Scott said. "And you'll make a good decision. So, if you do those things, you're gonna drive down healthcare costs."

He couldn't immediately pinpoint a number, but said the HSA payment should mirror the Obamacare subsidies being given.

The other side:

Democratic senators ended the shutdown while urging the house to vote to extend those subsidies, which are for those making between two and five times the poverty level of $16,000.

Premiums are also expected to sharply rise.

"I'm not terribly hopeful that we'll see a vote in the House," Scott Darius of Florida Voices for Health said. "And that's disheartening to say the least."

One health care group that has urged Florida to expand Medicaid, "Florida Voices for Health," warns that Scott's idea of HSA's would separate those who are generally healthy from those who need more extensive care.

Because the healthy would be unlikely to buy insurance, there would be little to offset the higher costs of caring for the sick.

"All this money that would go to HSA's and whatever plan is being talked about would be really siphoned out of the program," Darius said. "And I think [it] goes to further destabilize the ACA."

What they're saying:

Sen. Scott says states could re-start pools of high-risk patients, in hopes of capping out-of-pocket costs.

All sides have incentives to prevent the increase, for multiple reasons: Health care and politics.

"I've been meeting with, with the White House, I've been meeting with Democrats, I've been meeting with Republicans and saying, 'This is my, this is how the base structure works,'" Scott said. "We've got to reinvent this."

What's next:

The president has endorsed the idea of sending money directly to Americans to purchase health plans.

But how much will those payments be?

Are there enough members of Congress willing to rewrite those rules with an election year approaching?