Biden proposes massive new Obamacare subsidies, public option in health care plan

[ucrdem]

Mon July 15, 2019:

(CNN) Joe Biden is proposing massive new subsidies to make health coverage through Obamacare's exchanges cheaper -- as well as a new "public option" that would allow people to buy into a program his campaign says would be similar to Medicare.

The former vice president unveiled his health care plan Monday morning amid an escalating fight with his 2020 Democratic presidential foes as some more liberal candidates advocate enrolling all Americans in a national health plan, all but eliminating private health insurance.

Vermont Sen. Bernie Sanders is set to deliver a speech making his case for "Medicare for All" on Wednesday, according to his campaign. And California Sen. Kamala Harris, who has similarly backed a single-payer, government-run health program, teased the upcoming rollout of her plan in front of a crowd in New Hampshire on Sunday, too.

Biden, meanwhile, is pushing for a more moderate approach, built on former President Barack Obama's Affordable Care Act. "We should not be starting from scratch. We should be building from what we have. There's no time to wait," Biden told an audience in Dover, New Hampshire, on Friday.

https://www.cnn.com/2019/07/15/politics/joe-biden-health-care-plan-obamacare-public-option/index.html
..............

And the battle to save the ACA is joined . . .

[PDittie]

1. More

https://www.axios.com/joe-biden-health-care-plan-2020-affordable-care-act-1fac6458-b614-421a-a46b-1464b38e771e.html

Biden's new public option would automatically take the place of the Medicaid expansion in states that haven't expanded.

-- States that have expanded would have to keep paying their share of the bill for the expansion.

-- In other words, non-expansion states would get a better deal than those that participated in the expansion — arguably, rewarding their resistance to the ACA.

This ain't it, Joe.

[ucrdem]

6. Kind of an old story isn't it ... blue states overpay, red states underpay

But since those states have gone without the full benefit of the expansion at this point they'll need more help anyway don't you think?

[HerbChestnut]

18. You know what's a good way to help out those red states while also being fair to everyone else?

Single payer healthcare (aka Medicare for All)

[Cha]

2. Thank you, VP Biden.. he's in good company!

Joe Biden knows ACA is a BFD..

Link to tweet

Link to tweet

Progressives Support Shoring Up ACA Before Tackling Medicare For All

Despite a large division in the Democratic party over the best health care solution ― single-payer or a continuation and possible expansion of something like Obamacare ― progressives in Congress appear to be in lockstep with House Speaker Nancy Pelosi’s priority of shoring up the ACA before tackling anything like Medicare for All.

“I’m happy to support any provision that strengthens the ACA and plug some of the gaps that we’re seeing, particularly as it’s under assault by the president,” Rep. Alexandria Ocasio-Cortez (D-N.Y.) told HuffPost on Wednesday. “I think it’s part of a longer-term vision, at least for me, towards guaranteeing ― truly guaranteeing ― health care for all Americans.”

https://www.democraticunderground.com/10142293852#top

Looks like the House Progressives are with former VP Joe Biden

Here's Beto..

Link to tweet

Mahalo, ucr!

[ucrdem]

4. This is so great to see!

and good on Beto! Thanks Cha! !

[NYMinute]

15. Beto rocks!!

Biden-Beto 2020

[Cha]

22. We'll see!

[redstateblues]

26. Cha, You have the best posts!

[Cha]

27. Mahalo, redstatesblues!

[Thekaspervote]

33. Great post

Thx Cha

[Cha]

35. Thank you, Thekaspervote!

[ooky]

36. Ditto!

This is the much more grounded approach to health care we need to carry into the 2020 elections!

[Cha]

37. No kidding, ooky!

Thank You!

[onetexan]

39. great post Cha, thank you!!

Joe is right, we shouldn't have to start from scratch. Rather we should make it better.

[Cha]

41. And, that's was Obama's

plan all along! A strong foundation from which to grow..

Mahalo, onetexan!

[MontanaFarmer]

3. I like the idea in general,

But you can't/ shouldn't reward the non expansion states while leaving expansion states with higher costs. Maybe if the public option was phased into those states fairly quickly as well? I'm still in the camp that we won't get MFA done without a bridge. The reason i like where Harris, Warren, Sanders etc are coming from is by starting the process/negotiation from single payer, you have a better chance to land somewhere like this, instead of starting here and getting less.

[ucrdem]

5. I hadn't heard that but this is what I'd say if it came up:

First, the devil is in the details and it's hard to make that kind of prediction, and secondly, it's not so much a case of rewarding red states (if it comes to that) as providing health care for people who desperately need it. So I don't think this will be a deal breaker.

[MontanaFarmer]

9. Understood, but if you leave expansion

in place in states that did it, and do some form of public option in those that didn't as the substitute, there seems to be a great deal of built-in inequity in a system like that, or at least the potential for it. As you say, the details are important, so tough to judge at glance. But i desperately want us to end up with something akin to what Biden is proposing at a minimum, which leads me to prefer starting with a moon shot at MFA. Really, none of it matters unless you eliminate the filibuster anyway, but fun to discuss.

[ucrdem]

10. Yeah that would be strange.

Still it seems like one of those details that can be worked out, whereas starting a whole new system would be a tough sell, not just on the cost but because the negative ad campaign would be hard to defeat and would play into Trump's reelection campaign. Basically he'd run on scary slogans that would be micro-targeted to independents 24/7 just like last time.

[MontanaFarmer]

13. That I agree with.

Knowing how they work, though, anything any dem runs on will be the worst combination of socialism and fascism the world has ever seen, blah, blah. Whomever our candidate is, we need to be prepared to back their plan. If it's Joe, I can gladly support this plan, while desiring a little clarification on how it'll work in state A vs state B.

[Hortensis]

7. Definitely past time for the public option.

Hope all those who helped sink it and all the other planned improvements in 2016 remain wiser in 2020. The bipartisan commitment shown in the midterms was very encouraging.

At very best, another program would be an increment built on the start created by the ACA, but any of those would require years of delay to write, get passed, and then implement the roll-out to get one to where the ACA is now. Sanders estimated 5 years for that last alone.

Incredibly better to build on what is in place to go much farther much faster.

Of course, the Supreme Court's rulings on the cases intended to make the ACA unconstitutional at very least and all national healthcare programs at most will be a huge factor in the direction we take.

[ucrdem]

8. Sanders plan would take half a century to get to where we are now

The first 25 years would be spent in litigation, the second replacing all the hospitals, clinics and labs currently delivering employer-based health plans . . . and then we'd need another ACA to close all the loopholes in the new plan . . . meanwhile employers would scramble to replicate the benefit plans their employees were used to

[Hortensis]

12. :) I'm assuming Sanders' ill-planned extremist version is a no-go.

Forcing NO choice on all but those too wealthy to be affected? Stripping all rights to offer or receive potentially superior insurance as an employment benefit? Having no possible alternative option to go or compare to when Republican administrations cut benefits? It's unpassable.

No, it'd be one of the other proposals that best-selling new/old brand name, Medicare for All, has been tacked on.

"When someone tells you what he is, believe him."

[HerbChestnut]

17. I don't think you understand how single payer healthcare works.

Here's the basics from Wikipedia:

Single-payer healthcare is a type of universal healthcare[1] financed by taxes that covers the costs of essential healthcare for all residents, with costs covered by a single public system (hence 'single-payer').[2][3]

Single-payer systems may contract for healthcare services from private organizations (as is the case in Canada) or may own and employ healthcare resources and personnel (as is the case in the United Kingdom). "Single-payer" describes the mechanism by which healthcare is paid for by a single public authority, not the type of delivery or for whom physicians work, which may be public, private, or a mix of both.[4][5]

Single-payer healthcare systems pay for all covered healthcare-related services by a single government or government-related source.[6] It is a strategy employed by governments to achieve several goals, including universal healthcare, decreased economic burden of health care, and improved health outcomes for the population. Universal health care worldwide was established as a goal of the World Health Organization in 2010[7] and adopted by the United Nations General Assembly in 2015 for the 2030 Agenda for Sustainable Development.[8]

A single-payer health system establishes one health risk pool consisting of the entire population of a geographic or political region. It also establishes one set of rules for services offered, reimbursement rates, drug prices, and minimum standards for required services.[9]

In wealthy nations, that kind of publicly managed insurance is typically extended to all citizens and legal residents. Examples include the United Kingdom's National Health Service, Australia's Medicare, Canada's Medicare, and Taiwan's National Health Insurance.

Where did you get that we would have to replace hospitals?

[Autumn]

24. Yeah I want to hear that too. Having to replace hospitals is an excuse I've never head before.

[questionseverything]

28. they just like to say scarey stuff

n/t

[emmaverybo]

31. Better not to use UK as a model. Many many serious problems with NHS there, which increasingly

has had to privatize. Maybe better to look to Canada. As to a single payer system, fed-run in the U.S., the V.A.

[HerbChestnut]

32. Feel free to edit the Wikipedia page because that was their quote.

But you're right, there are plenty of single payer healthcare systems around the world that we can nick policy from.

[Lancero]

40. Hilarious to claim that MFA plans are going to spend years in litigation...

I forget, when was the first ACA lawsuit filed, and how many ACA related cases are STILL ongoing (read, tied up in litigation?)

It's disingenuous at best, and dishonest at worst, to claim MFA is bad compared to the ACA because 'years of lawsuits' when the the ACA is suffering from the exact same issue.

If you want to argue that a medical overhaul is bad because lawsuits, well... See the above. By that logic, the ACA is just as bad.

[ucrdem]

42. Sanders: "'You're damn right' health insurance companies should be eliminated"

That was in March: https://thehill.com/policy/healthcare/436033-sanders-youre-damn-right-health-insurance-companies-should-be-eliminated

So: what if those organizations (and their clients) don't want to be eliminated? That's 25 years of litigation, give or take a decade, and no, the ACA did not attempt to eliminate private insurance so there's no comparison.

Now about the real estate: once you eliminate Kaiser Permanente et al., you are going to have to start over unless you ACTUALLY want to keep them in the mix, only under a different arrangement, in which case, you're talking about the ACA. But M4A as Bernie envisions it means a massive, massive federal investment to re-invent a massive, massive wheel. Which is completely

[highplainsdem]

11. K&R

[NYMinute]

14. This is the best and only workable path forward

Everything else is just slogans

[Politicub]

16. Yes! We needed to hear specifics. And I like his proposal a lot.

The ACA is our best hope for increasing access to care and reducing costs. And the public option is a path to single payer.

[MineralMan]

19. That plan could certainly be implemented more quickly.

And that's very important in the immediate future. Trump has crippled the ACA, through Executive Orders and the courts. What he has harmed can be reversed in the same way.

We cannot have a breakdown of healthcare while a completely different system is created and installed. Too many people would die from lack of healthcare in the meantime.

So, Biden's plan would be the most effective, I think, and would protect people better than an undefined MfA plan that would need to be developed and passed in Congress. A transitional period is needed, not a sudden change of direction.

[Tarheel_Dem]

20. K&R

[msongs]

21. if MFA is not an electable position, adopting it is a loser idea. nt

[Scurrilous]

23. Thanks!

K&R

[betsuni]

25. K&R

[Lithos]

29. I prefer Single Payer (MFA, or whatever it is based on)

However, that's the end state. What Biden is offering is not that. Bernie's plan won't work without a lot of thrash that needs to be managed. I could see Biden's plan as a transition to Single Payer thru a gradual expansion of Medicare.

L-

[FloridaBlues]

30. Personally spending my entire life in heath care this makes the most sense

To start the change we need in HC. I agree with his plan. Over all HC systems is hugh trying to change this I'll take smart steps to making it better.

[Thekaspervote]

34. Right there with ya!! My experience of a lifetime in health care says/feels the same way

[oasis]

38. Full speed ahead with the "Game Changer" health plan. nt

[Cha]

43. ..