Bidencare would help millions of Americans
On Monday morning, America’s most prominent beneficiary of socialized medicine, in the process of receiving expensive, taxpayer-financed care at a government-run hospital, was tweeting furiously. One of President Donald Trump’s manic missives particularly caught the eyes of health care experts: his exhortation to “PROTECT PREEXISTING CONDITIONS. VOTE!”
As always, it’s not clear whether Trump is merely being cynical or whether he is also genuinely ignorant.
He’s definitely lying when he claims to have a plan that’s better and cheaper than Obamacare. No such plan exists, and he has to know that.
But does he know that Americans with preexisting medical conditions are already protected by the Affordable Care Act, which his administration is asking the Supreme Court to overturn? Does he realize that the reason his party has never offered an acceptable alternative to the ACA, in particular an alternative that would protect preexisting conditions, is that no such alternative is possible? That’s less clear.
In any case, how the nation votes will indeed make a huge difference to the future of health care — and not just because Trump, if he holds on to power, will almost surely find a way to destroy Obamacare, causing tens of millions of Americans to lose health insurance. Joe Biden, if he wins (and gets a Democratic Senate), will make a big difference in the other direction, substantially expanding coverage and reducing premiums for middle-class families.
The second part of this statement may come as news to many readers, because Biden’s health proposals haven’t drawn much attention so far.
While Biden is proposing incremental change rather than “Medicare for All,” we’re talking about some big increments. Independent estimates suggest that under Biden’s plan, 15 million to 20 million Americans would gain health insurance. And premiums would fall sharply, especially for middle-class families.
What policy changes are we talking about? To the extent that the Biden plan has received any attention at all, this attention has largely been focused on his proposed introduction of a “public option” — a Medicare-like plan that individuals could buy instead of purchasing private insurance. This option might be a first step toward a single-payer system, but it would be a small step, and in the near term would be much less important than other aspects of the plan.
First and foremost, the Biden plan — Bidencare? ObamaBidencare? — would substantially increase the subsidies that currently help many but not all Americans who don’t get insurance from their employers.
The Affordable Care Act, as passed in 2010, was underfunded, because Democrats wanted to hold down the headline cost. This meant that premiums and copayments were and are too high for many families.
The Biden plan would increase subsidies and remove the upper-income limit that prevents many middle-class families from receiving aid. This would cost a fair amount of money: The Committee for a Responsible Federal Budget puts the price tag at $850 billion over a decade. But it would cost far less than the 2017 tax cut, much of which went to corporations, which were supposed to respond by increasing investment, but didn’t.
The Biden plan would automatically enroll low-income Americans in the public option. A defect of our system is that it’s complex and confusing, and those who need help the most are often the least able to navigate their way to getting it. Ideally we’d just move to a simpler system, but for now auto-enrollment would be an important palliative measure.
Oh, and the plan would also provide significant aid for long-term care, rural health, and mental health.
So health care, including to PROTECT PREEXISTING CONDITIONS, really does need your VOTE! If Trump wins, Americans will lose that protection and many will lose their health insurance or see their premiums soar; if Biden wins, Americans will keep that protection and many will gain insurance or see their premiums fall.