Democrats mull ‘next big idea’ for healthcare policy

Tim Kaine speaking
Democratic Sen. Tim Kaine has floated a proposal known as "Medicare X," which would let people buy into a Medicare-like public insurance plan. (Gage Skidmore/CC BY-SA 2.0)

As Republicans wrestle with whether it’s feasible to repeal the Affordable Care Act this year, some Democrats are ready to push a healthcare policy agenda that goes beyond defending the current law.

“We’re tired of just playing defense,” said Sen. Tim Kaine, D-Va., told the Associated Press, adding, “It is now time to talk about the next big idea.”

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That next big idea could take a variety of forms, the article noted. It could be Kaine’s “Medicare X” legislation, which would give people in areas without insurer competition the option to buy into a public plan that uses Medicare’s reimbursement rates and provider network.

Another idea, first floated by Hawaii Democratic Sen. Brian Schatz, would give states the option of letting uninsured individuals whose incomes are too high to qualify for Medicaid pay a premium to buy into the program. Enrollees could use their ACA tax credits to help pay those premiums.

Then there’s the concept of “Medicare Part E,” in which people who don’t have access to employer-based coverage can join a new public health insurance plan that requires them to pay income-based premiums. Yale University political scientist Jacob Hacker is working with Democrats in Congress to turn the concept into a bill, the AP reported.

Democrats’ goal is to pick the best idea and coalesce behind it to give their 2020 presidential candidate a clear platform, the article added.

Republicans, meanwhile, are doing some calculations of their own. Though some in their party want to fully replace the ACA and take on entitlement reform this year, veteran lawmakers think it’s wiser to focus instead on selling the GOP tax plan, according to The Washington Post.

“Have to be careful, you know that,” Sen. Richard Shelby, R-Ala., said of the 2018 Republican agenda.

That’s especially true since Republicans would need to pass another budget resolution in the Senate in order to move legislation through with just a simple majority. In past election years, the article noted, Democrats avoided passing budgets since it’s not an ideal time to take on major agenda items.

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