Democrats reintroduce legislation to create Medicaid-based public option

Recently reintroduced legislation in the Senate aims to create a Medicaid-based public option, the latest effort by Democrats to return to a long-held priority. (Getty/kroach)

Nearly 20 Senate Democrats reintroduced legislation Friday to create a new Medicaid-based public option, reinforcing their commitment to a key priority.

But the legislation isn't certain to become law, as it has not been added to a $3.5 trillion infrastructure package that includes other reforms on drug pricing and expanding Medicare benefits. Nevertheless, the legislation underscores the commitment among the chamber’s Democrats to the issue that also has gotten support from President Joe Biden.

“Our bill will open up each state’s Medicaid program to anyone who wants it, giving people a high-quality, low-cost public health insurance option,” said Sen. Brian Schatz, D-Hawaii, one of the lead sponsors, in a statement. “Our ultimate goal here is to make sure that every single American has comprehensive health care coverage.”

The legislation would let states create a Medicaid buy-in program for all residents regardless of their income.

“Medicaid is a popular and cost-effective program with a large provider network,” a release on the legislation said. “The program has the same positive ratings as private insurance but provides health coverage at a much lower cost.”

The legislation could help state residents who may make too much to qualify for Affordable Care Act (ACA) income-based subsidies on the exchanges but don’t have employer coverage, the release added.

“The bill will also help consumers who live in counties with limited insurance carriers or who worry they may soon have no options for affordable coverage,” it said.

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The legislation, and a companion bill introduced in the House, is the latest bid by Democrats to create a public option.

Sens. Sheldon Whitehouse of Rhode Island and Sherrod Brown of Ohio introduced legislation back in March that adds a public option to the ACA’s marketplaces. Companion legislation was also introduced in the House.

The public option would include the same premium tax credits and cost-sharing help offered on the exchanges.

But it remains unclear whether either piece of legislation can make it through the Senate, where Democrats hold a 50-50 slim majority with Vice President Kamala Harris serving as the tiebreaker.

Democrats are planning to put together a $3.5 trillion infrastructure package that will be passed via a procedural move called reconciliation, which ensures budget legislation makes it through the Senate via a simple majority and bypasses the 60 votes needed to clear a legislative filibuster.

Several healthcare policies are likely to be included in the $3.5 trillion package, chief among them adding dental, vision and hearing benefits to Medicare. Democrats are also pursuing giving Medicare the power to negotiate for lower drug prices.

So far, Democrats have not confirmed that the public option will be included nor whether it would qualify to pass via reconciliation. The legislation has widespread opposition from Republicans.

Democrats have long sought to add a public option to the ACA after efforts to include it in the original legislation back in 2009 fell apart.