June Member Toolkit

Key Talking Points 

• The most effective way to expand access to affordable, high-quality health coverage and care is to build on what’s working in health care – not to create an unaffordable, new government-controlled health insurance system such as the public option or by opening up senior’s Medicare to younger Americans.  
• Increased subsidies have helped a record number of Americans gain access to coverage when they needed it most. 

• Building on our current system has led to the rate of Americans without health insurance dropping to a near historic low. 
• As Congress breaks and lawmakers look ahead to the midterm elections in November, building on and improving what’s working in health care is the future of health care reform that lawmakers should continue to focus on.  
• The 2022 Senate candidates are overwhelmingly focused on building on what’s working in our current system. Of the fourteen Senate Democrats running for re-election in 2022, only one supports Medicare for All 
• Because government-controlled health insurance systems are unaffordable and have negative, unintended consequences, there has been no movement by the Biden administration to include creating one in its agenda. 

Medicare for All 

• Research demonstrates Medicare for All could threaten existing coverage options and comes with an unaffordable cost to hardworking Americans.  

• A single-payer system could come with unprecedented costs, including a $24,000 yearly tax increase on the average family. (Urban Institute, 10/10/18) 
• A single-payer system could also triple payroll taxes and double other taxes. (Committee for a Responsible Federal Budget, 10/28/19) 
• Other research shows that taxes on high earners and corporations alone could not finance Medicare for All.  This could mean higher payroll taxes for hardworking American families. However, a payroll tax to finance Medicare for All would reduce GDP by 7.3 percent in 2030. (Committee for a Responsible Federal Budget, 3/17/20) 

• Research also shows that Medicare for All could lead to longer wait times, reduced access to care, and provider shortages.  Benefits may not address the unique needs of many Americans.  And reimbursement cuts could exacerbate our national nurse and physician shortage, reducing access and harming patient outcomes.   

• One study found that shifting the entire U.S. population to Medicare could result in an estimated 16% cut to spending on patient care provided by physicians. (FTI Consulting, 1/20/20) 
• When fully implemented, Medicare for All could result in a nationwide loss of 44,693 physicians by 2050.  (FTI Consulting, 1/10/20) 

• Medicare for All’s reimbursement cuts could result in 90% of hospitals across the country running consistent deficits, increasing the risk of hospital closures nationwide and negatively impacting the health care workforce.  (FTI Consulting,1/10/20) 
• If Medicare for All became law, 1.8 million health care jobs nationwide could no longer be needed, upending thousands of middle-class workers whose jobs largely rely on health insurance companies, including insurance brokers, medical billing workers and other administrative employees. (University of Massachusetts Political Economy Research Institute (PERI), 11/30/18) 

• Overall, Medicare for All could threaten current coverage for 250 million Americans by eliminating employer-provided coverage, the highly popular Medicare Advantage program, Medicaid Managed Care, and Exchanges. (Pollitz, Karen, et al. “The Henry J. Kaiser Family Foundation, 7/29/19) 

Public Option 

• The public option could come with unaffordable new costs for working Americans.  
  • The public option could harm the existing health care insurance system and cause premium increases for currently insured Americans, force a reduction in coverage options, and reduce access to care for seniors and low-income families. (Congressional Budget Office, 4/21)  
  • The public option could have significant impacts on America’s future fiscal condition and either increase the federal debt or require higher taxes on American families. (Lanhee J. Chen, Ph.D., Tom Church, and Daniel L. Heil, 2/3/21)  
  • In fact, the public option could be even more expensive for working families than originally projected.    
  • A public option could add $700 billion to the federal deficit in its first 10 years and would become the third most expensive government program behind Medicare and Social Security, both of which are already at risk for the seniors that rely on them. (Lanhee J. Chen, Ph.D., Tom Church and Daniel L. Heil, 1/24/20)   
  • Research found that, under the public option, the average American family could eventually see their payroll taxes increase by more than $2,500 a year and 10-year deficits could increase by $800 billion due to the public health crisis. (Lanhee J. Chen, Ph.D., Tom Church and Daniel L. Heil, 10/20/20)  Over 30 years, a public option could lead to a new 4.8 percent payroll tax or marginal tax rate increases for most American families to finance the new program. (Lanhee J. Chen, Ph.D., Tom Church and Daniel L. Heil, 1/24/20)  

• Creating the public option could harm patients’ access to the affordable, high-quality health care they need and deserve – including among vulnerable rural and minority communities.  
  • The public option could put a $774 billion financial strain on hospitals over a 10-year period, potentially forcing hospitals to reduce staff and eliminate services as they operate on a negative profit margin due to lower reimbursement rates. (KNG Health Consulting, 3/12/19)  
  • The closure of hospitals could decrease access to care in rural communities. A public option could put one in four rural hospitals at an increased risk of financial distress and in many of these communities, these hospitals are the only source of health care. (FTI Consulting, 7/14/21) 
  • Reductions in private payment rates may make it more difficult for rural hospitals to hire additional physicians or other health care professionals in areas already facing shortages of such workers. (Urban Institute, 3/21)  The public option could force health care providers to shorten appointment times, make staffing changes, or eliminate services in order to remain financially viable. This would diminish access to essential health care services for patients. (FTI Consulting, 7/14/21)  
  • The negative impact of the public option on hospitals could also harm communities where racial and ethnic minority patients are overrepresented and often rely on hospitals for their health care. Many of the hospitals already at risk for closure serve predominantly minority communities who could be left without a health care provider, especially in southwestern United States. (FTI Consulting, 7/14/21)  
  • The hospitals most at risk under the public option admitted more children and non-Hispanic Asian or Pacific Islander patients as a share of total admissions than hospitals with lower ratios of private to total charges. (Urban Institute, 3/21)  
  • Relative to specialized Medicaid managed care plans that prioritize care coordination and address social determinants of health, the public option may not provide the coverage necessary to meet the unique health care needs of at-risk, low-income populations. (FTI Consulting, 7/14/21)   

• Creating the public option could cause “significant disruptions” and “result in only a modest decrease in the number of uninsured persons compared to how many people would gain coverage through leveraging the public/private framework that exists under current law.” (KNG Health Consulting, 3/12/19)  
  • Overall, the public option could drastically alter the current health care market. It could drive an estimated 60 million people (40 percent of the market) out of employer-sponsored insurance which could potentially eliminate the entire private exchange market. (FTI Consulting, 5/21)  
  • A public option could force up to two million Americans off their current coverage and leave eight million Americans without a private coverage option. (FTI Consulting, 11/19/19) 

Medicare at 60 

• Opening up seniors’ Medicare to younger Americans through proposals like “Medicare at 60” could come with higher costs, worse quality of care, and an unaffordable price tag.  
  • Lowering the Medicare eligibility age to 60 could add $42.6 billion to the federal deficit in 2023 and increase 10-year deficits by as much as $452 billion (excluding interest costs). (Tom Church and Daniel L. Heil, 4/27/22)   
  • Hospitals and physicians could face steep cuts as millions are shifted from private insurance payment rates to lower Medicare rates. If Medicare at 60 were enacted for 2023, aggregate payments for hospitals and doctors would fall by $15.1 billion under the projected current-law rates. (Tom Church and Daniel L. Heil, 4/27/22)   
  • Over one-third of ACA marketplace enrollees could see their combined premium and out-of-pocket payments rise under the proposal, while gaining few additional benefits. (Tom Church and Daniel L. Heil, 4/27/22)   
  • To finance Medicare at 60, Congress could pursue various tax increases. This includes raising the additional Medicare tax rate by 285 percent or raising the standard Hospital Insurance (HI) tax rate by up to 12 percent in 2022. (Lanhee J. Chen, Ph.D., Tom Church and Daniel L. Heil, 6/23/21)   
  • Enrolling in Medicare could result in high costs for 60-64-year-olds that could otherwise be avoided in the current health care system. (Lanhee J. Chen, Ph.D., Tom Church and Daniel L. Heil, 6/23/21)   
    • Nearly 70 percent of this group currently receive subsidies and could end up paying more after transitioning to Medicare, particularly those with incomes above 135 percent of the poverty line.  
    • New Medicare plans could have higher cost-sharing requirements and add increased costs to families that are split between Medicare and Marketplace plans.  
    • “Medicare at 60” could negatively affect hospitals and medical providers that are already financially strained by reducing the reimbursement rates they receive. These potentially unsustainable cuts could mean lower quality and less access to care for the current Medicare-eligible population. (Lanhee J. Chen, Ph.D., Tom Church and Daniel L. Heil, 6/23/21)    
  • Already, Medicare is the second-largest single line item in the federal budget; it will soon surpass Social Security and grow more quickly than every other component. Under “Medicare at 60,” gross Medicare expenditures could rise by $82.9 billion in 2022 and total Medicare spending could rise by $995 billion over 10 years. (Lanhee J. Chen, Ph.D., Tom Church and Daniel L. Heil, 6/23/21)   
  • Absent alternative financing mechanisms, the Hospital Insurance (HI) Trust Fund would be depleted in 2024, two years sooner than currently projected.  (Lanhee J. Chen, Ph.D., Tom Church and Daniel L. Heil, 6/23/21)   

Government-Controlled Health Insurance Systems’ Poor Track Records  

• California’s latest proposal for single-payer health care in 2022 failed due to the proposal’s high cost of $222 billion per year. (Los Angeles Times, 1/12/22) 

• California’s previous single-payer proposal in 2017, which was estimated to cost $400 billion a year, could not pass in the state. (Cal Matters, 8/16/21) 
• Vermont lawmakers attempted to pass single-payer health care in 2011 but abandoned this plan due to high costs. (Health Affairs, 12/19/18) 
• In Washington, the state public option remains unpopular and unaffordable. 
  •  Public option premiums were on average higher than the lowest silver plan premium available in 2021. (NPR, 2/21/2022) 
  • Only 1% of people buying plans on the exchange chose public option plans in 2021. (NPR, 2/21/2022) 

Build on what’s working in health care  

• Improvements to current law are already helping to lower costs for Americans and increase access to health care.   
  • 3.2 million Americans selected a plan for $10 or less per month after the additional subsidies provided by the American Rescue Plan. (Department of Health & Human Services, 01/27/22) 
    • Expanded Premium Tax Credits have reduced monthly premiums for new enrollees by an average of 25 percent. Americans have been able to sign up for health insurance plans that have lower out-of-pocket maximums with the mean deductible for new consumers falling by nearly 90 percent. (Centers for Medicare & Medicaid Services, 5/6/21)  

• Since the ACA’s introduction, adult uninsured rates and racial and ethnic coverage inequities declined in nearly every state, particularly in states that built on what’s working by expanding Medicaid eligibility. (The Commonwealth Fund, 6/9/21)  
  • Nearly  35.8 million Americans have enrolled in Affordable Care Act (ACA) Market plans as of early 2022. (Healthcare Dive, 05/02/22) 
  • A record 14.5 million people signed up for coverage through the ACA exchanges for 2022. (Healthcare Dive, 05/02/22) 

• The American Rescue Plan lowered health care costs for most Marketplace consumers and increased enrollment to these records levels: Americans saw their average monthly premium fall by 23%, compared to the 2021 enrollment period that ended before the American Rescue Plan passed.   (Department of Health & Human Services, 01/27/22) 
  • The current health care system has lowered adult uninsured rates and reduced racial and ethnic coverage inequities in almost every state over the past decade. (The Commonwealth Fund, 6/9/21)  

• Recent polling shows that shows that lowering costs remains the top health care priority for voters of all parties – especially in a time of high inflation. The vast majority of voters – including Democrats – prefer for lawmakers to build on our current health care system rather than create the public option or open up Medicare to younger Americans. Most are unwilling to pay any more in taxes or health care costs to create a new government-controlled health insurance system. (Voter Vitals, 3/17/22) 
  • Lowering COSTS (63 percent) remains the top health care priority for Democratic, swing, and Republican voters.  
  • 64 percent of voters prefer BUILDING ON our current system rather than creating the public option, and 66 percent prefer building on our current system instead of opening up Medicare.  
  • Voters still prefer to build on what’s WORKING by providing subsidies for those in states that did not expand Medicaid to purchase coverage in the existing marketplace (57 percent) over creating a new government-run insurance plan (43 percent).  
  • The vast majority of voters remain CONCERNED about the access, cost, and long-term fiscal impacts of creating the public option or opening up Medicare.  

Sample Social Media 

64 percent of voters prefer BUILDING ON what’s working in health care rather than creating a new government-controlled health insurance system like the public option. Read our latest #VoterVitals to learn more: https://bit.ly/3Khkhfz  

DYK: Implementing a public option could force millions of Americans off their current plans and lead to higher health care costs. Learn the real costs of the public option: https://bit.ly/3gATJsi  

Proposals like Medicare at 60 bring an unavoidable trade-off between higher costs to taxpayers through higher federal deficits or cuts to physicians and hospitals. Get the facts on Medicare at 60: https://bit.ly/3EVKb6v 

Our latest #VoterVitals polling shows that the vast majority of voters remain concerned about the access, cost, and long-term fiscal impacts of creating the public option or opening up seniors’ Medicare to younger Americans. Learn more: https://bit.ly/3Khkhfz 

Building on what’s working in health care, where private coverage, Medicare, and Medicaid work together, has helped a record number of Americans gain access to affordable, high-quality health care coverage over the past 12 years. Learn more: https://bit.ly/3JaUBQ9  

Why start over by creating unaffordable, government-controlled health insurance systems like the public option when most Americans support building on what’s already working? Learn more: https://bit.ly/3Khkhfz 

America can’t afford to start over with unaffordable health care proposals. Let’s build on what’s working in health care, not add new costs and complications through proposals like Medicare at 60. See new research here: https://bit.ly/3EVKb6v 

Research shows that implementing Medicare at 60 could cost already struggling hospitals and doctors billions each year. Read the latest research to learn more:  https://bit.ly/3EVKb6v 

Our latest #VoterVitals shows that the vast majority of voters remain CONCERNED about the access, cost, and long-term fiscal impacts of creating the public option or opening up seniors’ Medicare to younger Americans. Learn more: https://bit.ly/3Khkhfz 

With Medicare for All, Americans could see their payroll taxes triple or all other taxes more than double. Get the facts on how Medicare for All could impact you and your family: https://bit.ly/3Dlk205  

DYK: Opening up seniors’ Medicare to younger Americans could bankrupt the Medicare trust fund by 2024? Learn the real consequences of proposals like Medicare at 60: https://bit.ly/3IORrl4