President Barack Obama is facing increased opposition after urging Congress to rehash the idea of allowing the federal government to offer an insurance plan as an option under the Affordable Care Act (ACA).
The “public option” has proven to be a point of contention. Initially included in the ACA version passed by the U.S. House of Representatives, the option was rejected in 2009 when a few conservative Democrats sided with Republican opposition in the U.S. Senate and voted against it. The bill needed the support of every Democrat in the Senate to pass.
The president called for a public option to be added to the ACA in an editorial published by the Journal of the American Medical Association on July 11.
“Now, based on experience with the ACA, I think Congress should revisit a public plan to compete alongside private insurers in areas of the country where competition is limited,” Obama said in the editorial. “Adding a public plan in such areas would strengthen the marketplace approach, giving consumers more affordable options while also creating savings for the federal government.”
Obama also urged Congress to avoid “moving backward” on health reform, adding that his administration has spent a considerable amount of time over the last several years opposing over 60 attempts to repeal parts or all of the ACA -- precious time that could have been spent improving the health care system and economy, he said.
“There are several problems with a public option,” Jason Pye, director of communications and justice reform for FreedomWorks, recently told Patient Daily. “First, this is likely an expansion of Medicare, a broken program that represents trillions of dollars in unfunded liabilities. Expanding it to more people is unwise from a fiscal perspective, given the new spending and significant tax increases that it would take.”
Such a measure would hurt economic growth since private investment would be crowded out, Pye noted, adding that many European welfare states spend 30 to 40 percent of their economy to fund similar programs and have exorbitant tax rates -- and “growth is lagging or virtually nonexistent.”
“The public option would destroy private health insurance coverage. Of course, that's the goal with the public option,” he said. “The federal government doesn't have to play by market rules, such as keeping premiums similar to private insurers. It can set premiums artificially low to attract customers. Private risk pools would likely be diminished, which would force insurers to raise rates.”
Complicating things further, Pye said, would be legislators trying to determine what treatments or surgical procedures the federal government will or will not pay for based on the age or health of the patient.
In February, pressured by Sen. Bernie Sanders' call for a single-payer government system, presumptive Democratic presidential nominee Hillary Clinton embraced the idea of including a public option for people age 55 and above to have the opportunity to purchase Medicare coverage.
“It's an election year, and the White House is trying to appeal to the radical, Bernie Sanders-supporting base of his party with what is the policy equivalent of a unicorn,” Pye said.
This past weekend, Clinton reportedly announced she would also strive to give Americans in every state the option to select a public option insurance plan as part of a Sanders deal.
“It's hard to see how he salvages his legacy; (economist) Jonathan Gruber once said that if single-payer supporters ever wanted to see their dream become a reality, then (Obamacare) and the experiment in Vermont would have to succeed,” Pye said. “Obviously, Vermont was a disaster. It never even got off the ground.”
The ACA may have brought the uninsured rate down, but Pye said other aspects of the health care law have been a failure, resulting in increased insurance premiums and limited provider options for consumers.
“One other example of this law's failures is the cooperatives,” he said. “Remember, this was the progressive alternative to the public option. But they've largely fallen apart.”
In a press release, FreedomWorks CEO Adam Brandon characterized Obamacare as “a creature of big government” that is “falling apart at the seams.”
“But rather than pursue patient-centered reforms, President Obama wants even more government involvement in our health care system,” Brandon said. “Americans, who’ve seen the failures of this law -- from its horribly botched rollout to its limited provider networks and costly premiums -- should reject this idea.”
FreedomWorks advocates the principles of smaller government, lower taxes, free markets, personal liberty and the rule of law.