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>>> Michael Bloomberg’s Health Care Plan: A ‘Public Option’ and Caps on Patient Fees

Mr. Bloomberg’s proposal, which would offer a government alternative to private health insurance, is similar to plans from some of his more moderate rivals in the 2020 race.

NY Times

12-19-19

https://www.nytimes.com/2019/12/19/us/politics/michael-bloomberg-health-care-plan.html


WASHINGTON — Former Mayor Michael R. Bloomberg of New York unveiled a health policy proposal on Thursday that would create a government-run health insurance plan but not provide universal guaranteed coverage, aligning himself with the more moderate wing of the Democratic Party in the 2020 presidential primary.

The plan, which he announced at a campaign event in Memphis, is among Mr. Bloomberg’s first policy rollouts. It echoes similar plans released by some rivals, including former Vice President Joseph R. Biden Jr. and Mayor Pete Buttigieg, which give Americans the option of buying public insurance but stop short of moving the entire country to a “Medicare for all” system advocated by progressives like Senators Bernie Sanders and Elizabeth Warren.

In a primary that has featured a fierce battle over how much a Democratic president ought to disrupt the health care system, Mr. Bloomberg’s plan places him firmly in the camp that believes smaller changes can make medical care more affordable while preserving the private insurance more than 150 million Americans receive through their employers.

Proponents of Medicare for all, by contrast, say the government should provide health coverage for everyone and want to eliminate most private insurance plans.

In staking out his position, Mr. Bloomberg is wading into a debate that has drawn the four leading candidates into heated exchanges. Mr. Biden and Mr. Buttigieg have warned that Medicare for all would force Americans to give up their existing health coverage, and have questioned how a universal government plan would be paid for. Mr. Sanders and Ms. Warren have said their rivals’ plans would maintain an unfair private insurance system.

Mr. Bloomberg instead focuses on building on the policies in the Affordable Care Act, a law that has faced consistent threats of repeal since its passage in 2010. The most recent effort is a lawsuit led by Republican attorneys general arguing that the health law is unconstitutional. A federal appeals court on Wednesday struck down the law’s mandate to purchase coverage, but sent questions about the rest of the law’s viability back to a district court.

Mr. Bloomberg, a billionaire who entered the race last month, has already poured an unprecedented sum of money into his 2020 bid, blanketing two dozen states with television and digital ads that, in a matter of weeks, cost more than $100 million and have made him the largest spender in the contest. He has seen his standing tick upward in national polls, to around 5 percent in some surveys, though he is still far behind the four leaders.

Mr. Bloomberg proposes creating a so-called public option that would be run by the government and that individuals could purchase with the health insurance subsidies currently provided by the Affordable Care Act. The plan would offer a set of benefits similar to those provided by Medicare, the federal insurance program that currently covers 60 million American seniors.

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In theory, a public option should be able to offer lower premiums because it has no profit margin and, working with the Medicare program, may have enough leverage to demand lower prices from health care providers.

The Congressional Budget Office estimated in 2013 that a public health plan would offer premiums 7 to 8 percent lower than private competitors in the individual market.

Mr. Bloomberg also proposes capping how much doctors and hospitals charge patients when they are out of network, meaning they do not have a contracted rate with the patient’s health plan. His plan would limit those charges to twice what the Medicare program pays for the given service. This would amount to a significant reduction to what some medical specialties, such as anesthesiology and emergency room providers, currently charge.

Those price limits have the potential to be powerful: A recent study published in the journal Health Affairs found that certain specialties, including radiologists and anesthesiologists, currently bill more than four times Medicare rates when they are out of network.

Mr. Buttigieg previously proposed a similar cap on out-of-network billing, also set at twice the Medicare rates.

Mr. Bloomberg’s plan would also ban surprise medical bills from out-of-network providers who see patients at in-network hospitals. Congress came close to passing such a measure this year but left the policy out of a year-end spending package after lawmakers became reluctant to pass a measure that would cut doctor pay.

The Bloomberg campaign estimated that, in total, his health plan would require an additional $1 trillion in tax revenue over the next decade. A senior policy adviser cautioned that the figure was preliminary and “loosey-goosey,” saying the campaign would follow up with a more robust financial analysis.

Mr. Bloomberg is the second candidate to roll out a health care platform this week, in a campaign cycle where the issue remains top of mind for voters. The entrepreneur Andrew Yang on Monday released a set of more incremental changes to the health system. He described himself as supporting “the spirit of Medicare for all” but did not propose a new government health plan. Instead, he suggested policies such as discouraging malpractice suits and expanding mental health coverage.

Mr. Bloomberg’s support for a public option in health care stretches back a decade to when he was mayor. He urged Congress to adopt such a policy in 2009, when Democrats were debating the law that would become the Affordable Care Act.

“I support the concept of a public plan, because if it’s done right, it means introducing exactly the kind of competition our system needs,” Mr. Bloomberg wrote in an op-ed published in The New York Daily News in 2009.

The public option ultimately fell out of the Democrats’ health plan after facing intense opposition from the health insurance industry and failing to get enough support from lawmakers.

Some candidates, such as Ms. Warren, envision the public option as a steppingstone on the path to a Medicare for all system. She has proposed passing a public option in the first 100 days of her presidency and expanding that into government coverage for all Americans by the end of her third year.

Bloomberg aides say their candidate does not see the policy similarly. For him, the public option is the final destination.

Mr. Bloomberg has criticized Medicare for all as an unaffordable policy for the United States. Different analyses suggest that a public plan to cover all Americans would require anywhere from $13.5 trillion to $34 trillion in new spending over a decade. Ms. Warren has pegged the figure at $20.5 trillion for her proposal.

“I think you could never afford that,” Mr. Bloomberg said in January at an event in New Hampshire. “You’re talking about trillions of dollars.”

“I think you can have ‘Medicare for all’ for people that are uncovered,” he added, “but to replace the entire private system where companies provide health care for their employees would bankrupt us for a very long time.”

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