June 27, 2019 | Updates

Democratic Senator Makes Case Against Medicare For All

WASHINGTON – U.S. Senator Joe Manchin (D-W.V.) this week became the latest high-profile Democrat to offer pointed criticism of Medicare for all.  As Democratic presidential contenders, including several of Manchin’s Senate colleagues, prepared to take the debate stage in Miami, The Hill reports that Manchin made the case for building and improving upon the progress we’ve made, not scrapping it in favor of a one-size-fits-all government-run system:

We can’t even pay for Medicare for some and to go Medicare for All, we can’t take care of those who are depending on it right now,” Manchin said at The Hill’s Future of Healthcare Summit.  Asked by The Hill’s editor-at-large Steve Clemons whose health care plan he most supports among Democrats running for president, Manchin deflected.  “I think all of them realize that what we have with ACA, it needs to be fixed,” Manchin said, referring to the Affordable Care Act.  “Now, they’re talking in their grand plan of what they want to do.  But then it has to come to fiscal responsibilities.  How do you do it?  Because those are major changes.  It’s easier to fix what we have now.”

A recent report from Medicare’s trustees supports Manchin’s concerns, painting a picture of the at-risk program’s future described in news reports as “troubled,” “shaky,” “grim” and “sobering.”  Underscoring the severity of the problem, The Wall Street Journal reports that the “latest projections suggest the [program’s funding] problem could affect not only future retirees, but also current ones.  Today’s newest retirees will be 72 when Medicare’s hospital trust fund is depleted … said Maya MacGuineas, the president of the Committee for a Responsible Federal Budget.  ‘That fact that we now can’t guarantee full benefits to current retirees is completely unacceptable…’”

Modern Healthcare notes that the trustees’ report “should cause concern for hospitals” because, as The Associated Press reports, the program’s projected shortfalls “could mean that hospitals, nursing homes, and other medical providers would be paid only part of their agreed-upon fees.”  With many hospitals already facing serious financial stress, The New York Times reports that experts are growing increasingly worried about the “violent upheaval” a one-size-fits-all health care system like Medicare for all would cause the nation’s hospitals, noting that “[s]ome hospitals, especially struggling rural centers, would close virtually overnight…”

Meanwhile, research also warns of the risks to hospitals and patients posed by so-called “moderate” fallback proposals, such as “public option” or “Medicare buy-in” schemes.  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 government insurance systems like “buy-in” or “public option” could force hospitals to limit the care they provide, produce significant “layoffs” and “potentially force the closure of essential hospitals.”

As former U.S. Senator Heidi Heitkamp (D-N.D.) recently wrote in The Washington Post“[c]hampioning a health-care policy that threatens to close rural hospitals and limit patients’ access to vital services is not a winning message” for Democratic candidates.

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