Dems: It's time for the ObamaCare public option

Dead in 2009, but resurrected out of desperation in 2017? Now that Senate Republicans have completely botched the repeal and replace effort on ObamaCare, everyone now gets to acknowledge what a dumpster fire the Affordable Care Act turned out to be. Two Senate Democrats have a new proposal to counter the single-payer progressives in their own caucus … sort of. Tim Kaine and Michael Bennet want to fix ObamaCare by bringing back an old proposal that had to get discarded the first time around — the public option, now called “Medicare-X”:

That’s where Bennet and Kaine come in, with what they call “Medicare-X,” legislation they are formally unveiling this week. It would allow anyone to buy into a Medicare plan, with lower-income workers receiving tax credits for the plan. In its first years of operation, this new Medicare option would be available only in counties that have one or no providers offering insurance on the ACA’s private exchanges.

It would eventually phase in to all counties and would effectively serve as what Democrats called the “public option” in 2009 and 2010, when they debated and passed the health law under then-President Obama. The public option, passed in the original draft by the House, could not clear a filibuster in the Senate and was dropped from the final bill. That came even though Democrats had 60 members in their caucus, enough to clear a filibuster, but several opposed a public option.

Bennet and Kaine are offering a proposal that they believe is both realistic and politically viable. The original targets for Medicare-X would be in rural areas that have been hardest hit by insurance providers fleeing the ACA exchange.

This would create, Bennet said in a statement given to The Washington Post, “a plan that begins to fix this problem by giving families and individuals a meaningful and affordable alternative.”

This differs from a proposal floated earlier by Claire McCaskill, which would have limited the “quasi-public option” (her description) to those 55 years of age and older. McCaskill wanted to find a way to get older but pre-Medicare Americans out of the exchanges in order to push premiums back down, which would create more incentives for younger Americans to comply with the ObamaCare mandate and stabilize the exchanges. There’s very little evidence to suggest that would work — younger/healthier Americans didn’t sign up in 2013 either, when the premiums were low — and the higher costs would just get transferred to either increased deficit spending or taxes on medical services.

Either way, it’s a bad idea — and an even larger destabilizing element, just as it was in 2009. Kaine and Bennet emphasize that Medicare-X will offer “an affordable alternative” to retail insurance, but how exactly will they guarantee that? By artificially keeping premiums low, and sticking taxpayers with the red ink. That will undercut what’s left of the competitive insurance markets. Now that Republicans have cut off all avenues of bailing out insurers at the expense of taxpayers, Democrats will simply cut out the middleman and produce oceans of red ink with this massive entitlement program expansion.

Don’t think for a moment that this is an alternative to a single-payer system. It’s an incremental step toward “Medicare for all” as the sole option left to Americans, just as it also was in 2009, and why it eventually had to get cut out of the ACA. Under McCaskill’s proposal, Medicare would crowd out insurance for the 55+ crowd; Kaine and Bennet would crowd it out altogether for all Americans without employer-based coverage, and even that exception would not last long. Kaine and Bennet’s Medicare-X is just a longer, more gradual, and decidedly less honest version of Bernie Sanders’ Medicare for All … just as the original ObamaCare proposal was.