WASHINGTON – Former Vice President Joe Biden recently released a new campaign ad which attempts to position the public option as a more moderate alternative to Medicare for all.  What the ad fails to mention, is that a new government insurance system like the public option would instead undermine the Affordable Care Act.

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

Meanwhile, Biden’s fellow 2020 contenders and others readily acknowledge such an approach would lead to the same one-size-fits-all government-run system, leading to higher taxes, worse care and longer waits.  And, a new study from Navigant finds that the public option could put more than 1,000 rural U.S. hospitals in 46 states “at high risk of closure.”  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.”

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