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Commentary By Manhattan Institute

4 Policy Ideas for the New Congress

President Trump delivered his State of the Union address Tuesday night, laying out his priorities for the nation. Now it’s time for legislators to start outlining their own policy agendas.

Check out these four innovative policy ideas that Congress can start working on today.

1. Health Policy

Next steps to reform the U.S. health care system

The cost of hospital treatment is a critical shortcoming of American health care, especially for emergency room patients who don’t have the freedom to shop around, and who are often hit with exorbitant bills that could bankrupt a family whether they have insurance or not.

As members of Congress set their priorities for health care reform this coming year, they should consider legislation that would protect emergency patients. One way to do this would be to restructure assistance to hospitals as lump-sum subsidies for uncompensated emergency care and cap fees for out-of-network emergency services at a percentage of Medicare’s administratively fixed rates. Such an approach would protect patients from the risk of surprise hospital bills without threatening the solvency of essential hospitals, or undermining the ability of insurers to negotiate good rates for the bulk of care. If connected to reforms of network adequacy laws, certificate of need laws, and other restrictions on competition for elective care, this type of legislation could provide the opening for the most essential health care reform that America needs. 

— Chris Pope, senior fellow

2. Education & Labor Policy

Policies to support the 21st century worker

Congress should begin to reallocate the tens of billions of dollars we spend each year on college subsidies toward support for vocational education and alternative pathways into the workforce. Pell grants reserved for traditional higher education should be directed toward shorter-term, technical training programs. Perkins funding, which provides only $1 billion per year to states for vocational secondary and post-secondary education, should be placed on a gradually increasing trajectory that gives states time to prepare for and deploy additional resources. Standards and metrics for non-college pathways should differ from those applied to the standard academic track. 

— Oren Cass, senior fellow and author of The Once and Futue Worker

3. Energy & Environment

Energy realities of the Green New Deal

The shiny new object in front of Congress is the Green New Deal, a proposal its backers say will “transform the economy and the environment” by eliminating the use of coal, oil, and natural gas and relying solely on renewable energy sources such as wind and solar.

But the Green New Deal’s promoters refuse to talk about the massive land-use impact any such effort would have. Promoters of all-renewable schemes inhabit a make-believe world where there’s endless amounts of vacant land—territory that’s just waiting to be covered with energy infrastructure. The truth is exactly the opposite. Across the country, from Vermont to California, local and state politicians are restricting the encroachment of renewable energy projects with wind energy and high-voltage transmission lines facing the staunchest opposition. As members of Congress look at ways to reduce carbon dioxide emissions, they should ignore the all-renewable dead end and instead make the preservation of existing nuclear plants a top priority. They should also focus on efforts that will help American companies develop next-generation nuclear reactors that are safer and cheaper than the ones we are using now.

— Robert Bryce, senior fellow

4. Tax & Budget Policy

A comprehensive plan to reform Social Security & Medicare

The annual budget deficit is projected to rise from $779 billion to $2.1 trillion over the next decade, under the current-policy baseline. This rising deficit will result almost exclusively from Social Security and Medicare’s annual shortfalls rising from $400 billion to $1.6 trillion over this period, including interest. By contrast, the $250 billion annual cost of the recent tax cuts, and $150 billion annual cost of the higher discretionary spending levels will remain steady, and thus do not explain the additional deficit rise over the next decade.

While the politics of entitlement reform are certainly brutal, there is simply no way to avert permanent trillion-dollar deficits unless lawmakers address the $100 trillion cash shortfall that Social Security and Medicare will face over the next 30 years.

— Brian Riedl, senior fellow