January 11, 2019
The concept of some form of single-payer health insurance is gathering steam at the federal, state, and local levels.
An upcoming report by the Congressional Budget Office will be the focus of hearings held by the House Budget Committee Chair John Yarmuth (D-KY). The hearings will initially focus on covering “the design considerations that policymakers should consider in developing proposals to establish a single-payer system in the United States.”
An “NYC Care” plan announced by Mayor Bill de Blasio will offer a public health insurance option on a sliding price scale based on income, which will begin in the Bronx this year and be available city-wide by 2021. It is projected to cost at least $100 million per year once fully implemented.
In one of his first official acts, Gov. Gavin Newsom (D-CA) signed a letter asking Congress to pass a new ACA waiver program to enable states to combine federal funds for Medicare, Medicaid, and veterans' health benefits with state funds into a single-payer system. The Governor’s proposed budget also calls for expanding the state’s Medicaid program and increasing ACA subsidies.
In other states: Washington Gov. Jay Inslee (D) wants to create a state-sponsored or public option health insurance plan that would include a pre-determined set of benefits and Medicare-level reimbursements for doctors. Meanwhile, the new majority in the Minnesota state house wants to create a “MinnesotaCare” buy-in plan option on the state’s exchange.
Take-away: State, local, and federal Democrats are developing policy ideas that could set the stage for federal action in 2021. While federal public-option and single-payer bills will not move in the Senate, the states are increasingly likely to serve as a testing ground for these ideas going into the 2020 election.