On Wednesday, June 12, 2019, the House Ways and Means Committee held a hearing with the intent to give Republicans and Democrats the chance to discuss other proposals to expand universal health care.  Generally universal coverage means government-run healthcare.  This was the first time a House committee of jurisdiction had formally assembled to examine universal health coverage, though the hearing shortly turned into the predictable and fatuous game of Republicans vs. Democrats.

Republicans focused on making it clear that Medicare for All would increase government spending significantly.  “The Costs of a National Single-Payer Healthcare System,” a study published by Senior Research Strategist Charles Blahous at George Mason University’s Mercatus Center, estimated that Medicare for All would increase federal budget commitments by approximately $32.6 trillion during the first 10 years of full implementation.  Stressing that universal coverage would eliminate all other forms of insurance, including the current Medicare program, was a main item on the Republican agenda as well.  

The Democrats invited patient advocate Rebecca Wood, Kaiser Family Foundation Director on Medicare Policy Tricia Neuman, Washington State Health Benefit Exchange CEO Pam MacEwan, and President Emeritus and Senior Fellow at the Institute for Healthcare Improvement, Dr. Donald M. Berwick to testify.

Serving as CMS administrator in a brief recess appointment from July 7, 2010 to December 2, 2011, just as the Patient Protection and Affordable Care Act (ACA) was being implemented, Dr. Berwick is a controversial figure and remembered for saying, “The decision is not whether or not we will ration care – the decision is whether we will ration with our eyes open.”  He resigned due to strong Republican opposition and his support of the British Health Service.

The Republicans invited Galen Institute President Grace-Marie Turner, a strong advocate for patient-centered and less government involvement in healthcare, to testify.

All the Democratic witnesses accused the GOP of having no policy reform plans while they defended government expansion.  Grace-Marie Turner explained the downsides of expanding government-run health care and offered different approaches to aiding the uninsured population and providing reasonably priced policies for all individuals through the private sector.

Rep. Lloyd Doggett (D-Texas) stated, “Today’s Republican condemnation of Medicare for All continues a great Republican tradition of opposing Medicare for anyone.”  Doggett also made it clear that Democrats are not in support of every aspect of Medicare for All, but they all believe it is the right direction for reforming healthcare in the United States.  He also suggested that the committee spend time ironing out the details implementing such a plan, though he spent most of the hearing focusing on criticizing Republicans rather than the merits of H.R. 1384.  

Donald Berwick offered testimony, arguing that Medicare for All should be a constitutional right.  He claimed that universal health care only makes sense for a nation founded on “the right to life, liberty, and the pursuit of happiness.”  In his written testimony, he said “In this crazy debate about whether or not health care is a human right in our nation, we have already made a choice – way back in 1965 – this it is a right for some of us.”

In her verbal testimony, Grace-Marie Turner emphasized that the most vulnerable patients would not receive access to the care they needed under a one-size-fits-all plan.  Turner was adamant on advocating for those facing lofty premiums and deductibles by stressing the importance of building competition in the individual market.  Her written testimony explained the new Health Reimbursement Arrangements (HRAs) rule implemented by the Trump administration on Thursday, June 12, 2019.  HRAs are favored by many Republicans because the new rule makes these plans more accessible and versatile, giving small and mid-sized employers and employees additional options in healthcare coverage.  Turner argued that the new HRA rule will help reduce the number of uninsured individuals.

Turner referenced research performed by Doug Badger, a senior fellow at the Galen Institute and a visiting fellow at the Heritage Foundation, who is a legislative strategist with a strong economic background.  Badger’s study demonstrates how states have used Sec. 1332 state innovation waiver authority under the ACA to create risk-mitigation programs and have lowered health insurance premiums.  The states also reallocate existing resources to protect and provide for those with preexisting conditions.  Ms. Turner said, “After the waiver reform in Alaska, premiums for the lowest-cost Bronze plans fell by 39 percent in 2018.”  Oregon experienced similar results and Minnesota, Maryland, New Jersey, and Wisconsin are following suit.

CAGW is urging a push against a single payer system such as Medicare for All and prefers the Health Care Choices proposal, offered by the Health Policy Consensus Group, because it is a patient centered, market-driven system for providing universal coverage. The Health Care Choices plan, led by former Sen. Rick Santorum (R-Pa.), would take the funding currently spent on Medicaid and ACA subsidies and create block grants that would be given to the states to support people’s purchase of private health care coverage, help low income people obtain coverage outside of Medicaid if desired, and offset the costs of high-risk patients while still ensuring they get the care they need.

CAGW is a part of the Coalition Against Socialized Medicine and joins other freedom fighters like American Conservative Union and the National Taxpayers Union.  On June 6, 2019, the coalition launched its fight against Medicare for All.

-- Angela McCallum