Many Americans struggle to manage the demands of work, family, and wellbeing in their busy lives. They expect us, as US senators, to carry their voices to Washington and craft legislation that is responsive to their concerns.
Health care is one of the most urgent issues for American families. It is about ensuring a sick child or elderly parent has the treatment they need. It should have nothing to do with partisan politics. But this year too many Americans have been inundated with headlines about plans to take away their health care, including this week’s news that Republicans want to repeal the Affordable Care Act’s individual mandate as part of their tax bill. This would lead to an estimated 13 million people losing insurance.
Americans want both parties to work together on real solutions that lower costs and increase choice without exploding our debt or upending lives. Last month, we announced legislation that would accomplish this. We call our plan Medicare-X.
For nearly a decade, Washington’s partisan bickering over the Affordable Care Act has prevented productive discussion about how to improve the law. The ACA has many strengths: it expanded health coverage for over 20 million Americans, it protects Americans with preexisting conditions, and it draws on ideas from across the political spectrum like expanding Medicaid and enabling young adults under 26 to stay on their parents’ health insurance plans.
But the law is imperfect. It does not go far enough to reduce costs and increase competition. And the dedicated efforts by President Trump to undermine the law have exacerbated these challenges. By ending cost-sharing reduction (CSR) payments and refusing to enforce the individual mandate, President Trump has put insurers in the impossible place of predicting what he will do next, causing them to raise rates and withdraw from markets.
This is especially true in rural America where the private insurance market often fails to deliver quality choices. In 2018, over 1,500 counties — many of them in rural America — will have just one option on the individual insurance market. And where competition is low, insurance companies often spike prices and offer plans with deductibles so high they are of little use. We owe these communities more choice and competition.
One solution is a public option, which would give Americans the choice to buy into a program run like Medicare. In the past, this idea enjoyed support from both parties. When Republicans passed Medicare Part D in 2003, they included a public option as a fallback for areas with little competition on the private market.
Similarly, Medicare-X revives a public option in our current health care debate. It would use the Medicare provider network, reimbursement schedule, and low administrative cost to deliver a high-quality product at a reasonable price that could be purchased on the individual insurance exchange. Starting in 2020, Medicare-X would become available to every individual in areas with one or fewer private plans on the individual market. By 2023, it would extend to every ZIP code in America. By 2024, Medicare-X would be available for purchase by small businesses.
Medicare-X would cover essential health benefits, including maternity care, pediatric services, preventive health, and emergency room visits. Americans could go online and compare Medicare-X with existing private plans to decide what’s best for their families.
Medicare-X would not increase taxes, increase the deficit or touch the Medicare trust fund. Because Medicare does not need to make a profit, pay taxes, or pay fancy salaries for corporate executives, the plan would be affordable. And those who currently qualify for a subsidy under the ACA could use it to bring their premiums down even further.
Our proposal would not fix every problem in our health care system. But it is a giant step forward: more choice, lower costs, no increase in taxes or the deficit. Medicare-X should appeal to both parties because it offers a real solution for Americans struggling with our current health care system.
