WASHINGTON – On the heels of last week’s Democratic presidential debates, in which candidates promoted controversial government-run health care proposals, the USA Today editorial board writes that “[i]t’s time for Democrats to get their priorities straight.”

The most expansive Medicare for All plans, offered by Sens. Bernie Sanders and Elizabeth Warren, would remake the American health industry in a way that would do away with private insurance.  Plans such as these are not happening any time soon, even if Democrats manage to win the presidency.  They won’t happen for the simple reason that too many Americans have private insurance that they either affirmatively like or would be apprehensive about losing for some uncertain alternative … That’s why preserving the ACA has to be the priority.  Enacting Obamacare was a big (bleeping) deal, as Vice President Joe Biden put it at the time.  The law needs champions who will oppose efforts to repeal it.  And it needs fixes that will shore up its shaky markets and exchanges.  

And while some candidates claim a new government insurance system such as the public option is a “moderate” alternative to Medicare for all, a new study from Navigant Consulting, Inc. reveals that the public option could put more than 1,000 rural U.S. hospitals in 46 states “at high risk of closure.”

The New York Times reports 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.

Meanwhile, The Associated Press reports 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.

###