October 27, 2021 | Updates

ICYMI: Building On What’s Working in Health Care Is Most Effective Way to Ensure Access to Affordable, High-Quality Care 

WASHINGTON – While policymakers continue to discuss proposals like creating the public option and opening up Medicare to younger Americans, there is clear evidence that government-controlled health insurance systems could result in unaffordable costs and negative consequences.  

Government-Controlled Health Insurance Systems Could Lead to New Taxes and Higher Costs  

  • One report revealed the public option “would 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
  • And, if health care expenditures increase quicker than currently forecasted, working families could see their payroll taxes increase by an additional $1,600 a year under the public option. (Lanhee J. Chen, Ph.D., Tom Church, and Daniel L. Heil, 2/3/21
  • “The public option would also prompt some employers, particularly smaller employers, to drop the plans they sponsor for their employees … Workers may be worse off, as they’ll have to use post-tax wages to pay for a public plan, rather than the pre-tax compensation they currently use for employer-sponsored coverage. An analysis of one public option plan introduced in the House in 2019 found nearly one in four workers would lose their health coverage through work by 2023. By 2032, that figure would rise to one in three.” (Janet Trautwein, A public option will destroy private insurance, Boston Herald, 6/5/21
  • Another report found that “under Medicare at 60, Congress could raise the additional Medicare tax rate by 285 percent in 2022, setting it at 3.5 percent in addition to the 2.9 percent for the standard Medicare payroll tax.” (Lanhee J. Chen, Ph.D., Tom Church, and Daniel L. Heil, 6/23/21
  • Economists at the Committee for a Responsible Federal Budget (CRFB) also found that lowering the Medicare age to 60 would cost $200 billion over 10 years. (Committee for a Responsible Federal Budget, 8/31/20

Building On What’s Working in Health Care 

  • A recent analysis revealed that proposed Affordable Care Act (ACA) enhancements, coupled with full Medicaid expansion, could lower premiums and lead to substantial coverage gains while preserving competition in the market and protecting choice for American consumers. (FTI Consulting, May 2021
  • Proposed ACA enhancements could reduce net premiums by 24 percent on average, saving consumers approximately $10.6 billion annually. (FTI Consulting, May 2021
  • Proposed enhancements to the ACA could achieve significant coverage gains – upwards of five million newly insured individuals – without the creation of the public option or significant disruption to those with private coverage or the health care system writ large. (FTI Consulting, May 2021

Millions Have Gained Coverage Through Existing Options 

  • There are now 12.2 million Americans enrolled in the federal and state marketplaces. (HHS, 9/15/21
  • The percentage of covered Americans rose in 2020, with the number of uninsured Americans decreasing by approximately 1.6 million, the CDC finds. (POLITICO, 8/31/21
  • In 2021, enhancements to current law made zero-cost premium plans available to 13.3 million Americans. (NPR, 8/3/21

At a time when Americans are depending on access to affordable, high-quality health coverage and care more than ever, Congress should prioritize building on and improving what’s working in health care. 


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