At about 6 pm yesterday, I received an invitation to a Heritage Foundation event titled, “Another Step forward for Free-Market Health Care Reform.” The event was anything but.


Heritage hosted Rep. Mike Rogers (R‑MI), who proposes to allow health savings accounts in Medicaid. In the book Healthy Competition and elsewhere, Cato scholars have explained that Medicaid HSAs are not a free-market health care reform and instead distract Congress from reforming Medicaid the way it reformed welfare in 1996.


In fact, Rep. Rogers proposed a number of non-free-market health reforms:

  • Expanded federal regulation of the health insurance markets (a.k.a. “association health plans”)
  • Federal health information technology reforms
  • Federal malpractice liability reform

Rep. Rogers concluded his opening remarks by saying that health care “is the one place where we know how to tinker, we know where to tinker, [and] now we just [need to] have the will to tinker.”


I demur. Free-market reforms reduce the influence of government over the economy. The proposals offered by Rep. Rogers do the opposite. Then again, I have only listened to the Heritage event. I have not seen the most recent iteration of Rep. Rogers’ legislation, which is not yet available online. I hope Rep. Rogers or someone from the Heritage Foundation will explain what makes Medicaid HSAs (or the other proposals) a free-market health care reform.