Delgado Introduces “Public Option” to Expand Healthcare

Congressman Antonio Delgado introduced a bill Monday to make a form of Medicare available to all Americans, fulfilling assertions on the campaign trail he would address what he has repeatedly called the “health care crisis.”

The bill would provide the “public option” of Medicare X, which would use existing Medicare physician networks but would keep its funding, raised through Medicare X premiums, separate from the Medicare trust fund already used by millions of elderly Americans. Those wanting to keep their private insurance could do so.

Delgado, who represents the northern Hudson Valley and Catskills, introduced the bill along with democratic Reps. Brian Higgins and John Larson Monday, saying it “will finally bring our country to universal health care coverage.”

The bill would introduce “more choice and more competition to the marketplace” and will “drive down costs for everyone,” he added.

Americans under 65 could apply to Medicare X through their insurance marketplace, according to the bill, which would offer a gold and silver option, with the possibility of other levels of coverage being offered. Enrollees would be charged premiums but would receive tax credits so their payments would ultimately not exceed a percentage of their income. A household earning within 138 percent of the poverty line would pay no more than 1.5 percent of their income on premiums, while a household earning more than 600 percent of the poverty line would pay no more than 13 percent.

Medicare X enrollees would use existing Medicare provider networks but would also have access to pediatric care and other youthful services not provided with traditional Medicare, according to the bill.

The plan would begin its roll-out in 2021 in areas where there is one or less private insurers on that area’s ACA marketplace, or “where there is a shortage of health providers or lack of competition that results in a high cost of health care services, including health professional shortage areas and rural areas,” according to the bill.

No counties in Delgado’s district, and therefore the The Other Hudson Valley’s coverage area, have only a single insurer, according to a review of The New York State of Health Marketplace, and it is unclear if any of these areas would fall under the “lack of competition” criterion.

Medicare X would be available to all individuals in 2024 and to small businesses in 2025, according to the bill. Medical providers would be reimbursed at the same rates they are for traditional Medicare, except for certain rural providers, which would be reimbursed at a higher rate.

The bill should mostly finance itself through premiums, but it does ask for $31 billion for the first three years for re-insurance and seed money, according to the bill, and a total price tag will not be ascertained until the appropriations process.

On a press call Wednesday, Delgado described how constituent concerns informed his endorsement of the bill.

“I think what I’ve heard more than anything is ‘how do we lower the cost of healthcare, how do we lower the cost of our premiums, our deductibles, and how do we do it now,’” Delgado said.

Delgado spoke to people who wanted healthcare for all Americans, but who also liked their employer-provided insurance, he said.

“[The bill] doesn’t pit people who are on the same side of the argument against each other,” instead offering options, Delgado said.

Delgado at a rally during the campaign last year.

Additionally, the bill would allow Medicare X to negotiate prescription drug prices with pharmaceutical companies, long a sticking-point for healthcare reformers. Delgado attacked his opponent, John Faso, during last year’s elections for not supporting the negotiation of lower drug prices.

The health insurance industry “has not expressed favor with this plan,” Delgado said, “and I’m not surprised by this.”

“Anytime you introduce more competition, anytime you design a healthcare bill that is prioritizing those seeking care and making sure that they have affordable options — the status quo is not going to be pleased with that,” he added.

The Senate version of the Medicare X bill was introduced this week by Senator and former Vice-Presidential candidate Tim Kaine and Sen. Michael Bennet.

The two introduced another version of Medicare X in the Senate in 2017, but it never came to a vote. The version introduced this week updates the 2017 bill by expanding tax credits for premiums.

A “public option” similar to the current proposal was also originally included in the ACA, AKA Obamacare, and the bill passed the House of Representatives with the measure intact, but, after contentious debate, the Senate passed the bill without a public option, due in part to opposition by Democratic Sen. Joe Lieberman, according to Health Affairs.

Since then, driven in part by the insurgent presidential candidacy of Sen. Bernie Sanders, the conversation has moved left, and calls for universal healthcare have increased. These include calls for a government-run national healthcare system, epitomized by Sanders’ “Medicare for All” proposal. The Medicare for All Act of 2019 has nearly half of democrats in the House signed on as co-sponsors, including such freshman Representatives as Alexandria Ocasio-Cortez and Ilhan Omar.

Delgado said he was in a good position to woo freshman representatives towards Medicare X as a freshman himself, “and I think [democratic congressional] leadership understands that fact.”

Delgado made healthcare a major part of his campaign, contrasting himself with John Faso, who voted to repeal the ACA in the House before the repeal was defeated in the Senate.

Delgadoss made a campaign commercial with Andrea Mitchell, a Catskill woman with a brain tumor who was infamously promised by Faso her health coverage would not be taken away before Faso signed onto the ACA repeal.

Update: This article has been updated to clarify the total costs of the bill are unknown.

Afterword: Clunky Press Calls

Press calls can be hilarious.

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