While Some Support Medicare-for-all, Other Lawmakers Embrace ‘State Public Option’

While Some Support Medicare-for-all, Other Lawmakers Embrace ‘State Public Option’


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Janet Ybarra
Former Washington Journalist
Contributor on The Bipartisan Press

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While much attention on Capitol Hill for the future of progressive healthcare reform is focused on Medicare-for-all, a group of lawmakers is pushing an alternative.

Since Democrats took control of the House in January, many have been looking at how to move beyond the Affordable Care Act (ACA), commonly known as Obamacare, and achieve universal coverage.

A single-payer Medicare-for-all approach has been popular among many Democrats, including some of those running for the 2020 nomination for president.

However, Sen. Dick Durbin (D-Ill.) and Brian Schatz (D-Hawaii) have joined Reps. Jan Schakowsky (D-Ill.), Raja Krishnamoorthi (D-Ill.) and Ben Ray Luján (D-N.M.) to introduce the State Public Option Act to create a Medicaid-based public health care option.

The State Public Option Act would allow states to create a Medicaid buy-in program for all residents regardless of income, giving everyone the option to buy into a state-driven Medicaid health insurance plan.  At least 14 states are exploring the implemention of a Medicaid public option within their legislatures, the supporters of the federal bill say.

A recent Kaiser Family Foundation survey found broad, bipartisan support for a Medicaid public option, the lawmakers add. Medicaid is a popular and cost-effective program with a large provider network, according to the bill supporters. The program has the same positive ratings as private insurance, but provides health coverage at a much lower cost, they add. Based on partnerships between state and federal governments, Medicaid also gives states the flexibility to adapt services and models of care based on their individual needs, the bill supporters say.

“In the last nine years, the ACA has made progress to reform America’s health care system, but we must do more to help cover 30 million Americans who remain uninsured,” says Durbin. “The State Public Option Act will help expand health care options so that everyone has an opportunity to find affordable coverage.  While the current Administration works to do everything they can to tear down the ACA, this bill will advance the fundamental right of affordable and accessible health care for all Americans.”

Dozens of other Democrats have signed on to co-sponsor the legislation in both the House and Senate, including presidential candidates Sens. Cory Booker (D-NJ), Kirsten Gillibrand (D-NY), Kamala Harris (D-Calif.), Amy Klobuchar (D-Minn.) and Elizabeth Warren (D-Mass.).

In at least a couple of cases, Gillibrand and Warren, they seem to be straddling the reform fence as they also have signaled support for Medicare-for-all.

Not surprisingly, not a single Republican lawmaker is associated with the State Public Option Act.

That means that, like much left-leaning reform legislation now taking shape in Congress, this bill could well pass the Democratic House, only to be probably never considered in the Republican Senate.

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