Our D.C. Bureau Proposal would expand Medicare

April 18, 2018 GMT

WASHINGTON — Sen. Chris Murphy delivered a proposal to offer Medicare to individuals and businesses as an alternative to private health insurance — even though any variation on the so-called “public option” stands no chance of passage in the GOP-controlled Congress.

In co-authoring the Choose Medicare Act with Sen. Jeff Merkley, D-Ore., Murphy, D-Conn., on Wednesday characterized it as a talking point for Democrats looking past last year’s failed GOP effort to “repeal and replace” the Affordable Care Act — Obamacare.

“Democrats have made it very clear that as we try to focus the country’s attention on fighting back against the president’s sabotage of the American health care system, we are also entertaining a very robust discussion about what to do next,” Murphy said at a news conference at the U.S. Capitol with Merkley. “It’s a moment where we let a half-dozen ideas blossom.”

The bill would create Medicare Part E, which would expand Medicare well beyond its primary role of providing health insurance to seniors over 65. It would open up Medicare to businesses and individuals as a form of competition to private insurance, which competes on the individual markets set up by the ACA, including Connecticut’s Access Health CT.

‘The market will dictate’

Murphy distinguished his proposal from another Medicare-for-all plan put forward by Sen. Bernie Sanders, I-Vt., which would essentially cut out private insurers and force recipients onto expanded Medicare.

“We think this will make the private insurance system much more competitive,” Murphy said. “Our policy should not be to protect insurance companies against a benefit that may be more attractive to Americans. I believe the market will dictate what Americans choose.”

Murphy said that if his bill were enacted, recipients would find Medicare Part E to be a better deal.

In 2010, lawmakers in the Democratic-controlled Congress kept a “public option” out of the Affordable Care Act. But now it’s back, as a discussion point for Democrats going forward.

The Murphy-Merkley bill “is the public option on steroids,” Murphy said.

The downfall of the Republican effort to replace Obamacare with a GOP plan has created a vacuum in the health insurance market, including in Connecticut. After the defeat, Republicans in control of Capitol Hill said they would move on to other topics, leaving the Obamacare superstructure nominally in place.

Murphy acknowledged Republicans are not at all likely to bring up any Medicare-expansion bill while they are in charge.

“This is not designed to be a bipartisan proposal,” Murphy said. “This is designed to start some real thinking within our party and across the country about what the health-care system should look like.”

Declining numbers

Healthcare.gov and state exchanges such as Access Health CT still exist, but rates have gone up in the face of Trump administration efforts to end subsidies for insurers.

Also, the Republican tax bill approved in December includes elimination of the lynchpin of Obamacare — the universal mandate, which requires all to have health insurance or pay a tax penalty.

Even so, Access Health CT signed up 114,134 by the end of the latest open enrollment period, which ended Dec. 22, 2017. At the time, the exchange said it represented a 2.3 percent increase over the previous open enrollment.

But an Access Health CT spokeswoman said the number had drifted downward to about 104,000 through natural attrition. Only two insurance companies are on the exchange, Connecticare and Anthem BlueCross BlueShield. Rates for both went up 16.7 percent for mid-level “silver” plans, according to the Kaiser Family Foundation, which tracks health care data.

In addition, about 55,000 in Connecticut get health insurance through Obamacare’s Medicaid-expansion program.

As a member of the Senate Health, Education, Labor and Pensions Committee, Murphy will be in the legislative vortex when health care arises next on Capitol Hill.

If Democrats take back either the House or the Senate — or both — in the mid-term election, reinvigorating the government’s role in the health care system likely would be at the top of the agenda.

If Democrats win, “I don’t know that Medicare-for-all is going to be first up in 2019,” Murphy said. “We’re going to have to do some very quick, hard work to restore affordability to a system the president is trying to destroy.”