Centrist Democrats Introduce Medicare Public Option Plan

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By Alex Ruoff

Two centrist Senate Democrats want to create a public option by allowing people to buy into Medicare via the individual health insurance market, starting with rural areas that have few insurers offering plans.

The bill, introduced by Sens. Michael Bennet (D-Colo.) and Tim Kaine (D-Va.), is meant to be a practical improvement for Obamacare, solving the issue of bare counties where only one or no insurers are offering individual health plans, Kaine told Bloomberg Law Oct. 19. In those counties, people would have the option of purchasing Medicare-style insurance plans. Eventually, the lawmakers’ plan would allow anyone to buy into the plans.

“We think we can solve a major problem and bring down costs for people, it’s that simple,” Kaine said.

While Kaine and Bennet are selling their plan as a practical improvement for the Affordable Care Act’s individual health insurance market, some Senate Democrats see it as the first step toward expanding Medicare to more of the population and eventually moving to a single-payer system, where the government is the sole provider of insurance.

The proposal has no supporters among Republicans, Kaine said, and therefore has little chance of being considered by any committees or coming to the Senate floor for a vote any time soon. The onetime vice presidential candidate, however, hopes his plan will provide Democrats a foil to Republicans’ plan to completely overhaul the ACA.

A public insurance option was originally included in the ACA, but it was abandoned partly due to a lack of consensus among Democrats. However, progressives since have grown increasingly supportive of the idea of a public option.

The Bennet-Kaine plan is co-sponsored by Sens. Ben Cardin (D-Md.), Dianne Feinstein (D-Calif.), and Patrick Leahy (D-Vt.).

Medicare-X

The Bennet-Kaine plan, the Medicare-X Choice Act, would create a public insurance plan on the individual and business marketplaces using Medicare’s network of doctors, similar reimbursement rates, and the comprehensive list of benefits required by all ACA-subsidized plans.

Those who buy the plans could still use the ACA’s tax credits to purchase a public plan.

A public option could strengthen the ACA by offering a government-backed option for rural areas of the country that generally face fewer choices and higher prices for insurance on the individual market, Bennet said in a statement.

It could also serve as a bridge to other big health policy ideas being advocated by prominent Democrats, Sen. Sherrod Brown (D-Ohio) told Bloomberg Law. Namely, it could pave the way for expanding Medicare to people 55 years of age and older, he said, and even single payer.

“These are good ideas, but we need a transition,” Brown said. “We need a way to get from here to there and this could be it.”

Some Senate Democrats haven’t backed Sen. Bernie Sanders’s (I-Vt.) single-payer bill because they see it as too drastic a change, Brown said.

Kaine told reporters Oct. 18 he doesn’t support single payer and sees his plan as supporting the private market, not replacing it.

To contact the reporter on this story: Alex Ruoff in Washington at aruoff@bna.com

To contact the editor responsible for this story: Brian Broderick at bbroderick@bna.com

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