Health consensus may be near
It’s all about health care. The 2020 election season has begun, with Democratic presidential candidates announcing their intentions and scurrying to define themselves before they get left behind. And the most important policy position they’ll need in their platform is what they plan to do about health care. A Pew Research Center survey this month found the economy and health care at the top of public concerns.
Finally, it seems that Americans understand it’s utterly ridiculous that we have made it so hard to access health care when every other modern nation in the world has figured it out. The growing demand for some form of universal coverage shows up in poll after poll, even as elected Republicans are celebrating a December ruling by a federal judge in Texas, currently being appealed, to strike down the Affordable Care Act, effectively eliminating coverage protections for people with pre-existing conditions and the Ten Essential Benefits that guarantee a base level of coverage for everyone.
New Democratic members of Congress are clamoring for change, citing Medicare for All as a solution, even though the details are still pretty fuzzy. Meanwhile, the Trump administration has announced new plans to privatize medical services at the Veterans Administration, despite the lack of support from veterans groups who are rightly suspicious of introducing a private sector profit motive into their resource-starved system instead of using that money to add more doctors and expand services.
Trump’s team is also trying to deny contraceptive coverage to workers on religious and moral grounds and issue block grants of Medicaid funds, giving states more theoretical flexibility. The real purpose of the block grants, of course, is to dramatically reduce Medicaid spending. Republicans have to pay for those tax cuts for the one percent, since the trickle-down shockingly hasn’t materialized for the rest of us.
As the D.C. health policy stalemate continues, new Democratic leaders at the state level are moving forward with their own agendas, and some of them are bold. California’s new governor, Gavin Newsom, wants to institute an individual mandate for insurance and use the increased revenues to expand subsidies. Sound familiar? He also wants to use Medicaid to insure undocumented adults, a proposal sure to send Trump and his supporters into fits of rage.
Another bold proposal comes from Washington’s governor, Jay Inslee, who says his Cascade Care will offer a state-run health care system similar to Medicare, available to individuals who would not be required to spend more than 10 percent of their income on premiums.
At least 10 states, including Nevada, are actively considering a Medicaid buy-in option for their citizens.
Allison O’Toole of United States of Care, an organization promoting affordable health care for everyone, told Stateline, “We think 2019 is going to be the year of Medicaid buy-in.” Her organization commissioned a Harris Poll in November. It found that 78 percent of the country’s registered voters believe a Medicaid buy-in plan should be a priority.
Washoe County’s Democratic Assemblymember Mike Sprinkle introduced the nation’s first such bill in 2017, which was passed by the Legislature only to be vetoed by Gov. Sandoval, who said more planning and review were needed. During the interim, Sprinkle has been working on the details which will allow anyone whose income is above 400 percent of poverty ($83,120 a year for a family of three) to opt into Medicaid with benefits that match Nevada’s existing Medicaid plan.
He told Stateline, “Because it wouldn’t be profit-driven, it would provide a level of stability that the market doesn’t have now.” Governor Sisolak has not yet committed to the concept.
Republicans stuck with ideology that health care should be earned or inherited may find themselves left behind at the ballot box in 2020 once again as voters demand action from their government, believing that access to health care is long past due.