Democrats Have More Universal Healthcare Plans Than Republicans Can Throw Gramma Off A Cliff At

Don't we all deserve a bed that goes up and goes down?

With the Republicans probably not quite ready to try killing off Obamacare again during an election year (nothing's guaranteed, though -- they may suddenly require poor people to deposit a kidney to get Medicaid), Democrats are floating a whole bunch of fun ideas for going beyond the Affordable Care Act. As the indispensable Sarah Kliff outlines over at Vox, there are at least five major universal-coverage plans floating around in progressive circles; in addition to a very popular Medicare for All bill in the Senate, there are also a whole bunch of proposals for public options, where individuals or employers could buy in to Medicare or Medicaid, plus a proposal from the Center for American Progress that would offer Medicare to everyone but allow private insurance to keep operating if people want it. Go check 'em out; they're all interesting!

It looks like our Dems is learning! Millions of people who have finally gotten a taste of decent healthcare from the ACA weren't in any mood to let the GOP take it away last year, and Democrats sure would like to mobilize the people who turned out in defense of Obamacare to show up and vote this year and in 2020. There's no shortage of good proposals, and yesterday, Senators Chris Murphy of Connecticut and Jeff Merkeley of Oregon added one more to the mix, a Medicare buy-in bill they're calling the "Choose Medicare Act," which has two words that Americans really like, and while it isn't single-payer, it would address several shortcoming of our current healthcare system (which isn't a "system" at all but a patchwork of public and private system s that just doesn't work so great unless you're fairly well off. You may have noticed). New York Times health policy reporter Margot Sanger-Katz outlines the bill in nice detail on the Tweeter machine. The Big Ideas in Murphy-Merkley are:

• It would allow individuals and employers to buy into Medicare. People getting subsidies on the Obamacare exchanges would also be able to purchase a Medicare plan. Premiums would be set according to enrollees' age and income.

• Murphy-Merkley (we like saying that) would fix one of the shortcomings of Obamacare: It would expand subsidies for health insurance (private or Medicare) to people making up to 600 percent of the poverty level (subsidies currently cut off at 400 percent of that level).

• Like most other Dem plans for health reform, it would allow Medicare to negotiate drug prices, and it would also set an out-of-pocket maximum for people receiving Medicare -- both retirees and people buying in to the plan.

One thing this isn't, and that's by design: It isn't single-payer, but would pave the way for single-payer by letting people buy into a program that most Americans already really, really like. Private insurance would still be an option, and by golly, if people would rather go that way, that's the "choose" part:  

"We think this is a way for the market to decide whether a Medicare plan or private sector plans are better for individuals and businesses," Sen. Murphy said. (He thinks most people will pick Medicare, but wants to preserve choice.)

As Sanger-Katz points out, since Medicare reimbursements are lower than private insurance, this plan is likely to get pushback from doctors, for-profit hospitals, and the medical device industry. But Murphy and Merkley are hoping the idea would be an easier sell than an immediate shift to single-payer -- and Merkley has signed on as a co-sponsor of the Senate Medicare For All bill himself. The health-reform nonprofit FamiliesUSA has already endorsed the Choose Medicare Act, and while we aren't certain it would be our first choice among the several very good ones, it looks like a very plausible plan. We need to get the healthcare discussion moving forward from a rearguard action to protect the ACA from all the Trumpfuckery, and to find ways of expanding healthcare to all Americans in a political reality where a third of voters are still really keen on letting people die if they can't organize a successful GoFundMe to cover their cancer treatments.

Mostly, we're just excited to see so many good ideas being floated for moving beyond the ACA, which most Americans finally seem to agree is both a good first step and not good enough. Go check out Sarah Kliff's piece at Vox for details on the Medicare/Medicaid buy-in plans being floated, too. A real fix to healthcare seems at least a possibility, even if we can't become Canada overnight. (But hey, maybe we could do that too, eh? First, we'll take Justin Trudeau.)

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[ Vox / Margot Sanger-Katz on Twitter]