Wellness Unmasked Weekly Rundown: Fixing America’s Healthcare: Dr. Nicole Saphier on ACA Failures, Subsidy Battles & Real Reform

Dr. Nicole Saphier breaks down the Senate’s rejection of both parties’ proposals to expand ACA subsidies—and explains why she believes lawmakers finally made the right call. Dr. Saphier offers a sharp critique of the Affordable Care Act, arguing that it has empowered insurance companies while driving up costs and reducing care quality for everyday Americans.

She outlines a conservative, patient-centered path forward, including targeted temporary subsidies, expanded Health Savings Accounts, true catastrophic coverage, and the restoration of physician-owned medical centers. With clarity and candor, Dr. Saphier makes the case that only market-driven reforms and a rollback of ACA mandates can restore choice, affordability, and access across the U.S. healthcare system.

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Episode Transcript

Speaker 1 (00:02):
Welcome to Wellna, Sun Mass. I'm doctor Nicoll Saffire and
this is your weekly rundown. Well, the Senate rejected both
the Democratic and Republican healthcare proposals, and frankly, this was
the right call. Now, if you haven't been watching the news,
there's a bit of urgency going on in Washington right
now because the expanded ACA subsidies that happened with COVID,

(00:24):
which is essentially a lot of federal dollars going to
insurance companies to help afford the Affordable aka Unaffordable Care Act.
They're set to expire in a couple of weeks at
the end of this month. Now, if those federal subsidies
are not expanded, millions of Americans are going to face
significant insurance premium hikes starting in early twenty twenty six

(00:48):
if they get their healthcare on the ACA marketplace. So
Democrats are saying, you absolutely have to expand those subsidies.
We do not want Americans having these high costs, and
Republicans are like, absolutely not. The Affordable Care Act has
failed and it is anything other than affordable. Well, so

(01:09):
in haste, you now have Democrats and Republicans trying to
put together bills by the end of the month to
try and fix this problem. And like I said, they
were both rejected, and that was the right call, because
whether it's Medicare for All on the left or some
half measures on the right, nothing is going to work

(01:30):
unless we address the real damage done by the Affordable
Care Act. So here's the reality. More than one third
of Americans skipped or delayed medical care last year because
of the costs. So that's not access to the care,
that's failure. The ACA shifted power away from patients and
doctors and handed it to the insurers and hospital systems,

(01:51):
fuel and consolidation, higher prices and ultimately lower quality. So
you don't fix healthcare by doubling down on what broke
it to begin with. A serious reform plan needs temporary
subsidy relief. Yeah, I know people don't want to hear it,
but you're going to have to give some money to
those subsidies because this is the bid they made. We

(02:13):
do not want Americans to suffer. So some sort of
temporary subsidy expansion, albeit maybe it should be reduced, and
there absolutely has to be a finite amount of time.
It shouldn't be two or three years, maybe six months,
maybe one year. Reality is for politicians, you want to
get people through the midterms, I get it. You also

(02:34):
need to enact aggressive fraud enforcement when it comes to
these subsidies and just ACA enrollment. Also take on expanded hsas,
those health savings accounts, the pre tax dollars. Not only
should you allow people to put money into it, but
also some of that subsidy money from the federal government.

(02:55):
It doesn't all need to go to the health insurance
Put some of that in hsas. For Americans, you want
to allow catastrophic coverage options because not everyone needs these
essential benefit plans from the Affordable Care Act. Let's think
of it when you think of oh gosh, let's think
of car insurance. Right, your car insurance doesn't cover you know,

(03:16):
filling up your tires and getting your oil change and
just doing all the basic care things that you do
to put along the life of your car. You have
car insurance for those catastrophic events like you get in
a big car accident or I don't know, if the
transmission falls out on the highway. That's what health insurance
is for. It's not to cover everything, like all wellness

(03:39):
visits and everything else that people are using their health
insurance for right now because of these mandatory essential benefits
put forth by the Affordable Care Act. That's a huge
reason why prices have gone off. Now. Another thing is
you have to bring back physician owned medical centers. They
outlawed it, said they couldn't do it. And so who's

(04:02):
now in charge of all the healthcare systems? MBA's venture
capitalists And what happened? What was a race to the bottom.
All of a sudden quality didn't matter, and you took
out a lot of that competition. And when that happens,
you're heading towards a socialized system. They essentially took away
the free market from our healthcare system. So what needs

(04:23):
to happen on the short term. You have to have
some sort of subsidy relief, and that means a short
term stop gap expansion of these subsidies. I think that
they should be reduced, and I think that there should
be a very small time that they are expanded for.
I think you need aggressive fraud enforcement with the ACA,
and you needed to expand the health savings accounts and

(04:44):
allow castrophic coverage options. More of the long term dismantling
the damage from the Affordable Care Act. You need to
bring back physician and medical centers, real price transparency, and
fewer prior authorizations standing between the patients and care. And
you really need to peel back the layers of those
essential benefits plans. Only then when you focus on that

(05:04):
short term and the long term, are we going to
begin to unravel the decade worth of damage the Affordable
Care Act has inflicted here in the United States. Put
patients and doctors back in charge, and health care is
going to start working again. Listen, this is not going
to be fixed in a week. It's going to take
a lot more time to peel back the layers of

(05:25):
damage the ACA has caused. But this is a start,
and I'm glad to see the conversation is back here.
We started at about eight years ago. Unfortunately COVID hit
it got delayed. But here we are again. But Republicans
and Democrats, you cannot rush this. This is very serious
and it affects everyone in the country. We need to

(05:46):
get back to a system where patients control the dollars,
quality will go up, costs will come down, and healthcare
can finally start working for the people it's meant to serve.
The Affordable Care Act was a poor attempt at socialized
medicine and it did just that. It drove down our
quality of care and it also drove up the cost
of health care. It was a disaster and it is

(06:07):
time to fix it, but we cannot rush it. This
is doctor Nicole Saffhire Wellness on MASS. Thanks so much
for listening. Make sure to tune in to Wellness on
Mass every Tuesdays and Fridays on iHeartRadio wherever you get
your podcasts, and I'll talk to you next time.