Democrats will force a vote in the Senate on Wednesday to try to roll back President Trump’s plans to approve sales of health insurance that falls short of Obamacare’s standards, hoping to get back on track after the bruising Supreme Court fight.
They insisted health care, not Justice Brett M. Kavanaugh, will drive voters to the polls next month, punishing Republicans for their efforts to roll back some of the 2010 health law’s strictures and guarantees.
The resolution Democrats will force a vote on is certain to fail — it’s unlikely to net the two Republicans needed to clear the Senate, and even if it did, the House already has fled Washington until after the election.
But for Democrats, Wednesday’s vote is about giving vulnerable senators, such as Sen. Tammy Baldwin of Wisconsin, new ammunition against GOP challengers.
“Anyone who says they support health care coverage for people with pre-existing conditions should support this resolution,” said Ms. Baldwin, who is the bill’s chief sponsor and filed a discharge petition late Tuesday with enough signatures to put her resolution on the floor.
The resolution uses the Congressional Review Act, which gives Capitol Hill a chance to veto new rules and regulations.
In this case the target is a rule that would allow companies to sell health plans that fall short of Obamacare’s full coverage menu, and to allow Americans to hold the plans for up to a year.
President Obama himself allowed consumers to hold short-term insurance for a full year until 2016, when he capped short-term plans at three months. Mr. Trump’s regulation would let consumers hold the plans for a year, and allow them to renew for an additional two years.
Republicans argue it would be perfect for customers who can’t afford Obamacare-compliant plans that are too pricey because they cover services the customers doubt they’d use.
“Short-term plans offer consumers a lifeboat — insurance policies they can afford,” said Doug Badger, a visiting fellow at the Heritage Foundation, a conservative think tank. “Congress shouldn’t sink the lifeboats.”
Democrats, though, fear younger and healthier customers will buy those plans, dropping out of the Obamacare markets that need them to subsidize costs for older and sicker Americans.
A Kaiser Family Foundation analysis of short-term plans offered on two major online markets — eHealth and Agile Health Insurance — found that 43 percent did not cover mental health services, 62 percent didn’t cover substance abuse treatment and none covered maternity care.
The Obamacare fight is playing out in the courts, where blue states have sued to stop the short-term plans proposal, and red states have sued to try to undo the rest of Obamacare itself.
Those red-state attorneys general argue that without the individual mandate forcing Americans to buy insurance — it was repealed by the 2017 tax-cut law — the rest of Obamacare must fall.
“Now that the individual mandate is a bad memory, people seem to have fallen in love with the residual parts of the ACA,” said Ross Baker, a political science professor at Rutgers University in New Jersey.
One of those residuals is the 2010 law’s requirement that insurers cover people with pre-existing conditions.
Democrats are wearing their support for the pre-existing conditions protections as a badge of honor, pointing back to last year’s vote in which the GOP failed to fulfill its repeal-and-replace promise on Obamacare.
“I was the deciding vote that saved coverage for pre-existing conditions,” Sen. Joe Donnelly, Indiana Democrat, said late Monday in a debate against Republican opponent Mike Braun.
Republican candidates insist they want to protect people with pre-existing medical conditions, just not the way Obamacare does it.
One option is to create high-risk pools where the government helps with costs. House Speaker Paul D. Ryan says that’s worked in Wisconsin. A recent study by a libertarian policy center found that Sen. Bernie Sanders’s (I-Vt.) “Medicare for all” plan would cost $32.6 trillion over 10 years, according to AP News.
The analysis finds that Sanders’s health-care plan, which he popularized as a talking point during his 2016 presidential campaign, would result in a significant increase in government spending because more people would make use of medical care, according to the AP.
“If every major country on earth can guarantee health care to all, and achieve better health outcomes, while spending substantially less per capita than we do, it is absurd for anyone to suggest that the United States cannot do the same,” Sanders said in a statement responding to the study.
Of course, we’re talking about the same Socialist Bernie Sanders who thinks Venezuela is a great place to be.
The analysis comes from the Mercatus Center at George Mason University, which receives funding from conservative mega-donors Charles and David Koch, according to the AP, which noted that Charles Koch sits on the center’s board.
“This grossly misleading and biased report is the Koch brothers response to the growing support in our country for a ‘Medicare for all’ program,” Sanders added.
An increasing number of Democratic lawmakers and candidates have come out in support of single-payer health care this election cycle after Sanders promoted the policy in 2016.
All U.S. residents would be covered by the proposed health-care policy without copays or deductibles.
Though Sanders’s office said it has not done an independent cost analysis on the plan, the amount identified by the Mercatus Center report is similar to what other studies have found.
The hikes would allow the government to replace what employers and consumers currently pay for health care — delivering significant savings on administration and drug costs, but increased demand for care that would drive up spending, according to the report.
According to the report, the legislation’s federal health care commitments would reach approximately 10.7 of GDP by 2022, and rise to nearly 12.7 percent of GDP by 2031.
But the study, conducted by senior research strategist Charles Blahous, said that those estimates were on the “conservative” side.
Sanders’ plan builds on Medicare, the insurance program for seniors. The proposal would require all U.S. residents be covered with no copays and deductibles for medical services. The insurance industry would be regulated to play a minor role in the system.
Sanders is far from the only liberal lawmaker pushing the program.
2020 hopefuls like Sen. Kamala Harris, D-Calif., and Sen. Elizabeth Warren, D-Mass., endorsed a “Medicare for all” program last year.
Political newcomer Alexandria Ocasio-Cortez, who beat House Democratic Caucus Chairman Joe Crowley, D-N.Y., in a recent upset primary and instantly became a prominent face of the democratic socialist movement, also is promoting a “Medicare for all” platform.
“Enacting something like ‘Medicare for all’ would be a transformative change in the size of the federal government,” Blahous, who was a senior economic adviser to former President George W. Bush and a public trustee of Social Security and Medicare during the Obama administration, said.
Blahous’ study also found that “a doubling of all currently projected federal individual and corporate income tax collections would be insufficient to finance the added federal costs of the plan.”
But Sanders blasted the analysis as “grossly misleading and biased,” noting that the Mercatus Center receives funding from the conservative Koch brothers. Koch Industries CEO Charles Koch is on the center’s board.
“If every major country on earth can guarantee health care to all, and achieve better health outcomes, while spending substantially less per capita than we do, it is absurd for anyone to suggest that the United States cannot do the same,” Sanders said in a statement. “This grossly misleading and biased report is the Koch brothers’ response to the growing support in our country for a ‘Medicare for all’ program.”
A spokesman for Sanders said that the senator’s office has not done a cost analysis on the new plan, however the estimates in the latest report are within the range for other cost projections for Sanders’ 2016 plan.
Sanders’ staff found an error in an original version of the Mercatus report, which counted a long-term care program that was in the 2016 proposal but not the current one. Blahous corrected it, reducing his estimate by about $3 trillion over 10 years. Blahous says the report is his own work, not the Koch brothers’.
Also called “single-payer” over the years, “Medicare for all” reflects a long-time wish among liberals for a government-run system that covers all Americans.
The idea won broad rank-and-file support after Sanders ran on it in the 2016 Democratic presidential primaries. Looking ahead to the 2020 election, Democrats are debating whether single-payer should be a “litmus test” for national candidates.
The Mercatus analysis estimated the 10-year cost of “Medicare for all” from 2022 to 2031, after an initial phase-in. Its findings are similar to those of several independent studies of Sanders’ 2016 plan. Those studies found increases in federal spending over 10 years that ranged from $24.7 trillion to $34.7 trillion.
The Mercatus study takes issue with a key cost-saving feature of the plan — that hospitals and doctors will accept payment based on lower Medicare rates for all their patients.
The study found that the plan would reap substantial savings from lower prescription costs — $846 billion over 10 years — since the government would deal directly with drugmakers. Savings from streamlined administration would be even greater, nearly $1.6 trillion.
But other provisions of the plan are also expected to drive up spending, with coverage for nearly 30 million uninsured Americans, no copays and no deductibles and improved benefits on dental, vision and hearing.
The study estimated that doubling all federal individual and corporate income taxes would not fully cover the additional costs.
James E Windsor, Overpasses News Desk
October 10th, 2018