7.31.19 / Updates

Biden’s Public Option Could ‘Threaten Obamacare’ & Is ‘Back Door To Medicare For All’

WASHINGTON – During tonight’s Democratic presidential debate in Detroit, former Vice President Joe Biden is expected to make a case for his proposed new government insurance system, known as the “public option.”  But while often described as a “moderate” alternative to Medicare for all, Biden’s fellow 2020 hopefuls acknowledge that the “public option” or “buy-in” systems he and others support would also lead to a one-size-fits-all government-run health care system.

While Medicare for all would eliminate private health insurance overnight, Biden’s public option would eliminate private health insurance over time – leading to higher taxes, worse care and longer waits.

During the first round of presidential debates, Senator Kirsten Gillibrand (D-N.Y.) said: “The truth is, if you have a buy-in over a four or five year period, you move us to single payer more quickly,” adding that under such a system, “our step to single payer is so short,” and Mayor Pete Buttigieg (D-Ind.) emphasized that a “buy-in” or “public option” system “will be a very natural glide path to the single payer environment.”  Senator Cory Booker (D-N.J.) added to the consensus, saying: “Medicare for all is what we should be going for, but the first step getting there has to be showing that we can create a public option, or allowing Medicare to be available for more people” in a recent interview with CNN’s Dana Bash.

NBC News reporter Jonathan Allen explained to viewers recently that “[t]he public option is essentially a back door to Medicare for all.  You can say all day long if you want it’s not Medicare for all.  But this is a different packaging of how to get there.”  And The Wall Street Journal’s Kate Bachelder Odell explained recently that the public option “cannibalizes the private market” and “where you end up over time is not that different” from Medicare for all, as it would “get rid of private insurance over time, versus this swift transition” under Senator Bernie Sanders’s (I-Vt.) Medicare for all legislation.

Earlier this year, The Wall Street Journal reported that the “public option” and similar new government insurance systems represent “stepping stones to single payer, a fact acknowledged by supporters of such proposals, including Senator Chris Murphy (D-Conn.), who recently admitted it would bring about the “slow death” of employer-provided and other private coverage and serve as an “on ramp to a single-payer system.”

Experts also confirm that the “public option” would lead America to a single, government-run health care system – and have warned that it will drive costs up for those on private plans.  Dr. Scott Atlas of Stanford University explains that a “public option” would “mainly erode, or ‘crowd out,’ private insurance, rather than provide coverage to the uninsured” and “would cause premiums for private insurance to skyrocket,” as he recently wrote in The Wall Street Journal.  And the Pacific Research Institute’s Sally Pipes explains that “[a] public option would gradually destroy the private insurance market – and ultimately result in single-payer healthcare … [D]octors and hospitals would need to raise the rates they charge private insurers in order to balance their books.  Insurers would raise premiums in response, and yet more people would jump to the public option. The cycle would repeat, until private insurers found themselves without any customers.  Eventually, the public option would be the only option.”

Meanwhile, in a story headlined “How a Medicare Buy-In or Public Option Could Threaten Obamacare,” The New York Times reports this week that “a 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.

In addition to its substantial risks to consumers and taxpayers, research also warns of the risks to hospitals and patients posed by so-called “moderate” fallback proposals like the “public option.”  One study found that “[f]or hospitals, the introduction of a public plan that reimburses providers using Medicare rates would compound financial stresses they are already facing, potentially impacting access to care and provider quality.”  Another study found that new government insurance systems like “Medicare buy-in” or “public option” could force hospitals to limit the care they provide, produce significant “layoffs” and “potentially force the closure” of some hospitals.

new poll released by the Partnership for America’s Health Care Future this week reveals that voters prioritize improving our current health care system over offering a new government insurance system, often referred to as the “public option.”  Voters across party lines prefer a presidential candidate focused on making those improvements over one who wants to expand government insurance systems, and majorities also “believe that negative outcomes, such as increased taxes and fewer employer-based options, are more likely to occur than positive ones if a government health care program that people could choose were put into place – and most believe it would be unlikely to improve their health care or that of their family.

Notably, The Associated Press reports this week that “[g]overnment surveys show that about 90% of the population has coverage, largely preserving gains from President Barack Obama’s years.  Independent experts estimate that more than one-half of the roughly 30 million uninsured people in the country are eligible for health insurance through existing programs.

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