U.S. Health Care System

The BYU Law Health Law Club hosted a lecture by Greg Matis, Deputy General Counsel at Intermountain Healthcare and adjunct faculty member at BYU Law, on Monday, January 30. Matis discussed the challenges of the U.S. healthcare system, the requirements of the Affordable Care Act, and possible “repeal and replace” reforms that may evolve during the Trump administration.

In his overview of the health care system, Matis said that there is no real U.S. healthcare system. Rather, the “system” consists of many different systems, including private insurance companies, Medicare, and Medicaid. In addition, the health care system is financially unsustainable. He said there are “a lot of crazy incentives that need to change,” both for sustainability and for better health care.

Matis addressed some of the tenets of the Affordable Care Act and how those policies have impacted the overall system. The requirement that everyone qualifies for and is required to have coverage made it so many uninsured Americans received coverage. At the same time, providing for this mandate has changed costs and coverage of health insurance for many Americans.

Addressing what the new administration may have in store for health care, Matis said  total repeal and replacement will not be possible. “It cannot take immediate effect for both political and practical reasons,” he said. It took four years to implement the Affordable Care Act legislation, and the new vested entitlements will be “the hardest thing in the world to replace.”

Instead of a wholesale replacement, Matis said it appears that the Affordable Care Act may be replaced with an emphasis on consumerism and health savings accounts along with the return of state high risk pools. He said that certain elements of the Affordable Care Act will likely be kept, such as the requirement for patients with preexisting conditions to receive coverage.