Much of the public discussion about health care and health insurance reform abounds with misinformation. Medicaid, in particular, has become a political tool, with daily posts and articles about reforms to the program that distort the record for political gain. But there is little mention of the need to empower governors to take ownership of the program.
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The government’s price tag for a single-payer health care system would be astonishing. When Sen. Bernie Sanders (I-VT) proposed a “Medicare for all” health plan in his presidential campaign, the nonpartisan Urban Institute figured that it would raise government spending by $32 trillion over 10 years, requiring a tax increase so huge that even the democratic socialist Mr. Sanders did not propose anything close to it.
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As the Republican Congress struggles to “repeal and replace” Obamacare, the political landscape is steadily shifting.
Since the Democratic Congress enacted Obamacare in 2010 (without a single Republican vote), Democrats have increasingly been on the defensive about their creation. The individual mandate that Obamacare relied upon to corral healthy young people into insurance pools has failed to do the job – partly because the tax penalty was not severe enough, and partly because the Obama administration felt compelled to create 14 different types of “hardship exemptions” that exempted millions of young people from the penalty.
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Recall that under Democratic Governor Peter Shumlin Vermont committed to a single-payer for the state but had to abandon the effort in 2015. Why? The cost was staggering — $4.3 billion when Vermont’s entire fiscal 2015 budget, including both state and federal funds, was about $4.9 billion. That’s right: essentially doubling the size of the government.
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While Senate Republicans are drafting their healthcare plan behind closed doors, they’ve given reporters a general idea of what might be in it.
- It will slow down the phase-out of the Medicaid expansion
- Tax credits will be beefed up
- It will keep some ObamaCare taxes
- It will include more funding to combat the opioid crisis
- It will try to stabilize the ObamaCare exchanges
- It will include more funding to handle preexisting conditions