The following is excerpt from Jordan Weissmann | August 23, 2017 | Slate.com |
With Obamacare repeal defeated for the time being, Democrats have begun looking ahead and crafting plans to expand health coverage to the millions of Americans who still remain uninsured. On Tuesday, Vox previewed one such proposal from Sen. Brian Schatz of Hawaii, which would let middle- and upper-income Americans buy into Medicaid through the Affordable Care Act's exchanges. “Exclusive: Sen. Schatz’s New Health Care Idea Could Be the Democratic Party’s Future,” declared the somewhat breathless, if technically accurate, headline. (I mean, Dwayne Johnson could be the Democratic Party's future, too.)
When I asked Schatz's office for more details, I was told the bill is still a work in progress with some pieces subject to change. But after reading a draft summary of the plan that's been making the rounds in health-policy circles, it strikes me more like an old idea with some important new twists: Schatz wants to bring back the concept of a strong public option on the Affordable Care Act's exchanges. Medicaid just happens to be the vehicle to do it.
As you no doubt recall, Democrats spent much of the 2009 Obamacare wars arguing over whether to create a government-run health plan to compete with private insurers. But even among public-option advocates, there were two camps. On one side, you had progressives, including Sen. Bernie Sanders, advocating a “strong” public option that would save costs by using the same doctor payment rates as Medicare. Moderate and conservative Dems saw this as a step too close to socialized medicine and preferred a weaker public option that would have to negotiate rates with providers just like Aetna or Humana.
In the end, both ideas proved objectionable to industry-friendly centrists like Connecticut's Joe Lieberman. The public option died.
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