Amid Trumpcare’s Demise, Public Option Emerges Ahead Of 2018 Elections

Forbes reports:

“A public option as an alternative or addition to subsidized private individual coverage under the Affordable Care Act is gaining momentum on the campaign trail ahead of next year’s 2018 midterm Congressional and gubernatorial elections.

The public option is being pushed by Democrats running for office and members of Congress as a response to the failed Republican-led Congressional effort to repeal and replace the ACA. The public option is also gaining momentum in states as an alternative to more progressive single-payer healthcare proposals that would have the government control health insurance and require more taxpayer dollars.

In Illinois, for example, a Democrat campaigning to unseat the unpopular incumbent Republican Gov. Bruce Rauner is pushing a lower cost public option to more expensive plans on the ACA’s  exchanges.

“I propose a public health insurance option that would allow every Illinois resident the chance to buy low-cost health insurance,” Democrat J.B. Pritzker said in announcing his proposal last week. Pritzker is a billionaire businessman and brother of former U.S. Commerce Secretary Penny Pritzker who served in the last term of Barack Obama’s White House.

J.B. Pritzker’s public option would allow Illinois residents to buy into Medicaid coverage for the poor “to provide another choice in the health insurance marketplace, to lower the cost of premiums and mitigate market uncertainty at no cost to taxpayers.”

Pritzker bases his plan on current costs for a public option to Illinois taxpayers as “about $3,350 per year per adult and $2,108 per child for Medicaid.” A detailed actuarial analysis would be needed, Pritzker said, and analysts say the federal government would likely have to sign off on it. Pritzker’s campaign sees it as a more realistic option for the financially strapped state than a taxpayer supported single-payer expansion of health benefits.

“As a Medicaid buy-in option, IllinoisCares would require Illinoisans who do not receive federal healthcare subsidies to pay premiums to cover the full cost of Medicaid coverage,” Pritzker’s public option proposal says. “As a result, there should be no additional cost to taxpayers for this program. Participants who qualify for ACA tax credits could use those to help pay for their premiums.”

On the federal level, Democrats in the U.S. Senate and U.S. House of Representatives see a public option as a way to expand Medicare to younger Americans after GOP legislation, known as Trumpcare, failed.

Just last week, several Democrats in the Senate including Tammy Baldwin (D-Wisconsin), Sherrod Brown (D-Ohio), Al Franken (D-Minnesota) and Debbie Stabenow (D-Michigan) introduced the “Medicare at 55 Act” that would allow Americans to buy into Medicare at age 55 . “For people between the ages of 55 and 64, this is a high quality option that can help reduce health insurance costs and increase competition,” Baldwin said.

A group of Democrats in the U.S. House have also pitched a public option idea that would also be for Americans who aren’t eligible for Medicare. Such public options would be an alternative to private coverage offered on public exchanges.

Executives at health insurance plans like Aetna, Humana and UnitedHealth Group that have pulled Obamacare plans off public exchanges have made their decisions after being unable to manage costs of newly insured sick patients. Many of these customers tend to be in their 50s and early 60s with multiple chronic conditions.

It’s unclear how public option plans would better fare with costs of sick patients, but the House idea includes allowing people to buy into Medicare Advantage plans, which certainly have a larger risk pool of patients in markets across the country than the current crop of ACA-compliant plans.

“Allowing the option for some consumers to buy in to Medicare as they approach retirement age could allow for additional affordable and reliable options through traditional Medicare and Medicare Advantage programs,” the proposal by about 10 House Democrats including Rep. Kurt Schrader of Oregon.”