ICYMI: Public Option Could Leave Rural Patients With ‘Fewer Options’

WASHINGTON – As some candidates and elected officials continue to push for a new government insurance system known as the public option, Lauren Crawford Shaver, the Partnership’s executive director, explains in an interview that a new study by Navigant finds such a system could put more than half of rural U.S. hospitals at a high risk of closure, meaning patients in already underserved areas would “have to even travel further to get the care that they need and will have fewer options in getting that.”  Virginia Public Radio reports:

As many as 10 rural hospitals in Virginia could close if the federal government starts offering a public option health plan — the kind of public option that’s now being talked about on the campaign trail by former Vice President Joe Biden and others.  That’s the conclusion of the Partnership for America’s Health Future.  Lauren Crawford Shaver is the executive director of the partnership, and she says the lower reimbursement rates from the government plan would put a squeeze on rural hospitals.  “Those communities are already typically underserved and do not have access to all of the newest and most advanced medical treatment or physicians and specialists,” Crawford Shaver says. “They are going to have to even travel further to get the care that they need and will have fewer options in getting that.”

The new study, conducted by Navigant, found that the “public option” outlined in several current proposals, could put more than 1,000 rural U.S. hospitals in 46 states “at high risk of closure,” including half of rural Virginia hospitals.  A separate study released by Navigant in March found that the “public option” could cause increased financial stress, force hospitals to limit the care they provide, drive significant “layoffs” and “potentially force the closure of essential hospitals.”  As Kaiser Health News and NPR report, hospital closures can have “profound social, emotional and medical consequences.”

And while some continue to promote the public option as a more “moderate” alternative to Medicare for all, 2020 contenders and others readily acknowledge such an approach would lead to the same one-size-fits-all government-run system, and the first edition of Voter Vitals – a new quarterly tracking poll conducted nationwide and in 2020 battleground states – finds that “[h]ealth care will be the defining issue of the 2020 presidential election. However, a clear majority of voters nationwide are primed to reject new government-run systems that will cost voters more to expand coverage like Medicare for All, the public option, and Medicare buy-in.  Most voters want candidates to lower costs, build on what’s working and fix what’s broken – not start over.”  This tracks closely with recent polling conducted by the Kaiser Family Foundation, which finds that the majority of Americans, including Democrats and Democratic-leaning independents, want our elected officials to build and improve upon on our current system.

In a story headlined “How a Medicare Buy-In or Public Option Could Threaten Obamacare,” The New York Times reported recently that the “public option may well threaten the A.C.A. in unexpected ways.”

A government plan, even a Medicare buy-in, could shrink the number of customers buying policies on the Obamacare markets, making them less appealing for leading insurers, according to many health insurers, policy analysts and even some Democrats … [A] buy-in shift in insurance coverage could profoundly unsettle the nation’s private health sector, which makes up almost a fifth of the United States economy.  Depending on who is allowed to sign up for the plan, it could also rock the employer-based system that now covers some 160 million Americans … Siphoning off such a large group of customers could also lead to a 10 percent increase in premiums for the remaining pool of insured people, according to the Blue Cross analysis.  More younger people with expensive medical conditions have enrolled than insurers expected, and insurers would have to increase premiums to cover their costs, Mr. Haltmeyer said.  Tricia Neuman, a senior vice president at the Kaiser Family Foundation, which studies insurance markets, said a government buy-in that attracted older Americans could indeed raise premiums for those who remained in the A.C.A. markets, especially if those consumers had high medical costs … Dr. David Blumenthal, the president of the Commonwealth Fund, a foundation that funds health care research, said a government plan that attracted people with expensive conditions could prove costly.  “You might, as a taxpayer, become concerned that they would be more like high-risk pools,” he said.