With the government shutdown over, it’s time to get back to work on fixing America’s health care. Even Obamacare supporters now admit their health plan has failed. Despite promises of decreasing premiums, the sad truth has come to light. Over ten years in, Obamacare has become part of the problem, not the solution. Premiums keep rising, deductibles skyrocketed, enrollees have fewer choices than before, and plans have become more restrictive.   While more subsidies might mask some of those premium increases, they do nothing to solve Obamacare’s other problems. The reality? Health care costs are increasing across the board. What’s needed now is a plan to make American health care affordable again—not just to hand out more government subsidies to more people, but to make health care less expensive and more accessible for all Americans. President Donald Trump’s instincts are right, both on fixing Obamacare and on making the overall health system more affordable for everyone. When it comes to Obamacare, Trump has floated the idea of giving enrollees their subsidies in an account they can use to buy the plan of their choice. That would be an improvement over Obamacare’s current design under which the subsidies go directly to the insurer. However, the process for calculating subsidy amounts also needs restructuring , as the current design is opaque, overly complex, and fuels premium increases. Giving people a health account empowers them to decide how and where to spend on health care because whoever controls the dollars controls the decisions. That basic concept has already been embraced—in the form of Health Saving Accounts—by a growing number of employers and workers. Indeed, a survey by the American Bankers Association reported that, as of last year, there were 39.3 million HSAs, benefiting 59.3 million people. Beyond Obamacare, there are a number of ways to expand access to health accounts and make them more consumer friendly. The Working Families Tax Cuts bill, enacted this past summer, made several key changes to expand access to traditional Health Savings Accounts.  First, it allows all bronze and catastrophic plans in the Obamacare Exchanges to be HSA-eligible plans. According to the Centers for Medicare and Medicaid Services,  this means at least 1.6 million additional HealthCare.gov consumers. Second, it clarifies that individuals who have a direct primary care arrangement with a health care provider are not prohibited from contributing to an HSA and an individual can use their HSA to pay for direct primary care memberships. Third, it permanently extends telehealth services as non-deductible. There are a number of related policy recommendations that were under consideration during the reconciliation process but were left out of the final agreement. Those recommendations included, for example, increasing the amount low-income individuals could contribute, better coordinating HSAs with Flexible Spending Accounts and Health Reimbursement Arrangements , allowing individuals to use their HSA accounts for gym memberships, and allowing them to use an HSA if they access an onsite employer clinic. Other recommendations included efforts to codify the Individual Health Reimbursement Arrangements and incentivize small employers to adopt them. Many of these proposals have held bipartisan support in the past and could be reconsidered. Thinking bigger, certain other proposals would supercharge health accounts.  For example, Sen. Ted Cruz and Rep. Chip Roy, both Texas Republicans, have proposed the Personalized Care Act, a bill that would make health accounts available regardless of whether they were tethered to a high-deductible health plan. Meanwhile, the Health Out-of-Pocket Expense (HOPE) Act, which has bipartisan support in the House and Senate, would also establish new Roth-style accounts for individuals to help pay for and save for their health care expenses.   Both bills represent innovative ways to increase patient control over health care dollars and decisions. Expanding access to health accounts is a strong foundation for change, but to make these accounts really work, consumers need information. The best way to do this is to demand radical transparency in health care prices. Trump led the way with price transparency in his first administration and has continued this effort in his second administration. To boost these efforts, the Centers for Medicare and Medicaid Services should issue rules  implementing the No Surprises Act’s requirement for health plans to provide “Advance Explanations of Benefits” so Americans can receive a “good faith estimate” of their costs before receiving care. The administration should also direct the Department of Labor to issue rules enabling employers to access claims data held by the third-party administrators managing their employees’ health plans. For far too long, health care prices have been a black box. Demanding radical price transparency is the key to holding the large and opaque health care industrial complex accountable. Here too a bipartisan duo in the Senate have proposed a path forward.Sen. Roger Marshall, R-Kans., and Sen. John Hickenlooper, D-Co., introduced the Patients Deserve Price Tags Act, which would allow group health plans to access their claims data; require public reporting of negotiated rates, costs, and cash prices for certain services; and require providers and facilities to include detailed itemized bills. Policy changes should not focus solely on Obamacare or on the 15 million subsidized under Obamacare. They should also provide relief to the 160 million Americans covered by employer and union plans. There is no shortage of ideas for making health care coverage more affordable for all Americans. Many of those ideas even have bipartisan support. The question is whether politicians will choose to take on the health care industrial complex and actually help the American people by giving them more control over how and where they spend their health care dollars.  The post Don’t Expand Obamacare, Make Health Care Affordable Again appeared first on The Daily Signal.