John Desser: Health Savings Accounts and Market-Based Healthcare Solutions

Joe Grogan talks with John Desser, VP and Head of Government Affairs at Health Equity, about market-based healthcare and why Health Savings Accounts (HSAs) may be its future. John's 35-year career runs from an internship in Senator John McCain's office through the Bush administration, eHealth, and now Health Equity. He recounts how the ACA's first draft nearly wiped out private online insurance marketplaces, why healthcare.gov stumbled, and how consumer control can fix healthcare's misaligned incentives. He also reflects on Ron Wyden's universal coverage plan without a mandate, Ted Kennedy's role in bipartisan reform, McCain's skinny repeal vote, and Trump's "give the money to the people" approach. Key Timestamps 1:10 Joe welcomes John Desser of Health Equity 1:26 From foreign policy major to healthcare policy 1:46 Falling into healthcare in McCain's office, summer 1989 2:40 35 years in healthcare, thanks to Dave McIntyre 3:18 Coalition for Affordable Health Coverage and refundable tax credits 4:45 Bill Thomas: Spend as much as Democrats, but spend it our way 6:11 Updating the Archer MSA law 7:30 How Bill Thomas put HSAs in the Medicare Modernization Act 8:06 Leading health policy in the Bush administration 10:45 The uninsured project and Ron Wyden's universal coverage bill 12:03 Why dropping the mandate cost zero coverage 15:09 eHealth: Selling insurance online for a decade 17:05 Waxman's ACA draft and the 100% premium surtax 19:54 The John Dingell meeting that removed the surtax 21:14 The healthcare.gov disaster 22:55 Marketing costs: $20,000 per healthcare.gov sign-up 27:06 Trump administration launches enhanced direct enrollment 30:22 John joins Health Equity in July 2022 30:54 Why HSAs matter: Consumers, not bureaucrats, should ration care 34:18 Trump's "give the money to the people" instinct 35:35 The problem with arbitrary value-based pricing 39:21 ACA criticism: Ted Kennedy's absence and the 60-vote problem 41:51 Why bipartisan healthcare laws are more durable 44:15 "Build a new house next to the old one" 44:50 John Goodman's case for HSAs in Medicaid 45:28 Why every employer plan should include HSAs Key Topics HSAs, market-based healthcare, the ACA, healthcare.gov, online insurance marketplaces, Medicare Modernization Act, Medicaid reform, employer-sponsored coverage, bipartisan healthcare policy, consumer-driven healthcare About the Guest John Desser is VP and Head of Government Affairs at Health Equity, the nation's largest HSA provider, with 17 million total accounts. In more than 35 years in healthcare policy, he has worked for Senator John McCain, led health policy at HHS in the Bush administration, and run government affairs at eHealth during the ACA rollout. He is an expert in consumer-driven healthcare and market-based reform. Podcast: DC EKG with Joe Grogan | Episode: 141 | Host: Joe Grogan | Guest: John Desser, Vice President and Head of Government Affairs, Health Equity Sponsor: Survivors for Solutions – https://survivorsforsolutions.org Executive Producer: John "CZ" Czwartacki, DC EKG Podcast | Producer: Stay on Course Studios