Dem senators introduce plan for ‘public option on steroids’
Millions more Americans could pick Medicare as their health insurer under a bill introduced by Sens. Chris Murphy, D-Connecticut, and Jeff Merkley, D-Oregon, by making it a public insurance option on the Affordable Care Act (ACA) exchanges and for employers.
Expanding insurance options through Medicare has been a central theme in recent Democratic healthcare proposals, including the single-payer “Medicare-for-all” option and the “Medicare Extra” plan from the Center for American Progress (CAP), a liberal think tank.
While not guaranteeing universal healthcare, as the single-payer proposal would promise, or offering a new option for current Medicare beneficiaries like the CAP plan, Murphy and Merkeley’s “Choose Medicare” legislation would allow employers and individual market customers to be insured under a new Medicare plan called “Part E,” which Murphy said would act like the ACA’s abandoned public option only “on steroids."
“Every individual and every business should have the right to buy into Medicare, and our bill allows this to finally happen,” Murphy said in a press release.
Employers and individual market customers wouldn’t be required to replace their plans with Medicare Part E. For those shopping on the ACA exchanges, however, it could serve a more attractive option from the current offerings, where premiums have risen by double-digit percentages over the past two years and narrow networks are the norm.
Medicare Part E would require premiums, set by state insurance commissioners based on the same ACA factors like age and geographic region, therefore divorcing the new plan from the Medicare Trust Fund. Exchange customers could use their premium support subsides to cover some or all of the cost and far more would have that support available, as the bill would expand subsidy eligibility to 600 percent of the federal poverty level, allowing individuals with annual income up to $72,360 based on 2017 figures to qualify.
The bill would also:
- Extend the ACA rating requirements to all insurance markets, including the large group market.
- Include coverage for abortions and reproductive services in Medicare Part E.
- Establish an out-of-pocket maximum in Medicare.
- Allow Medicare Part D to negotiate on drug prices.
Some of those provisions would be sure to stir up fierce opposition from Republicans as well as healthcare groups like the American Hospital Association which have opposed expansions of Medicare. It may also outline the divisions among Democrats on healthcare reform efforts. Even its sponsors are split in some ways, as Merkley said he remains a supporter of single-payer.
“I am very supportive of the vision for Medicare-for-all and I want us to find a path to get there,” he said during a conference call with reporters on April 17.
Murphy, however, doesn’t support the Medicare-for-all legislation. He said he wants enrollment in this new option to be voluntary and predicted Medicare-for-all wouldn’t be able to be passed quickly, even if Democrats were in control of both houses of Congress and the White House. He also said he doesn’t want to totally eliminate private health insurers, but instead give them a new competitor.
“Our policy should not be to protect insurance companies against a benefit that may be more attractive to Americans,” Murphy told reporters. “I believe the market will dictate what Americans choose.”
John joined TriMed in 2016, focusing on healthcare policy and regulation. After graduating from Columbia College Chicago, he worked at FM News Chicago and Rivet News Radio, and worked on the state government and politics beat for the Illinois Radio Network. Outside of work, you may find him adding to his never-ending graphic novel collection.