President Obama is calling on Congress to add a “public option” to ObamaCare to improve his signature health law.
The pitch from Obama comes after he abandoned pursuit of a government-run insurance plan to compete with private insurers during the long legislative battle over healthcare because of opposition from some Democrats in Congress.
“Public programs like Medicare often deliver care more cost-effectively by curtailing administrative overhead and securing better prices from providers,” Obama writes in the Journal of the American Medical Association.
“The public plan did not make it into the final legislation. 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,” writes the president.
The new embrace from the president also comes amid what appears to be a concerted push by the Democratic Party to rally around the public option.
It’s a shift that reflects how the party has tilted leftward during the Obama years.
Hillary Clinton emphasized a public option in an announcement Saturday that was interpreted as a play for supporters of Sen. Bernie Sanders (I-Vt.), who ran a surprisingly strong campaign against her for the Democratic presidential nomination.
Sanders has pushed even further for a government-run, “single-payer” system.
A public option has no real chance of passing Congress, at least with Republicans in charge of the House.
Indeed, aides say that Obama will not be pressuring Congress to pass these changes during his remaining time in office and is instead laying out ideas for future policymakers.
In his article, Obama touts progress made under the Affordable Care Act (ACA) while laying out work for the future. He also calls for an increase in the financial assistance that the law provides, acknowledging that some families still “struggle with premiums.”
The article is the result of a months-long review of what is and is not working in the ACA, requested by Obama late last year, the White House said.
Overall, Obama touts the law as a resounding success. He notes that administration economists estimate that 20 million people have gained coverage because of the law and the uninsured rate has fallen to a record low, under 10 percent.
There has also been progress on cost, with a slowdown in the growth in health spending, which experts attribute in part to ACA reforms that seek to shift to payments that reward quality health outcomes rather than simply the number of services provided.
The Congressional Budget Office’s estimates for the cost of the law’s coverage expansion are about 25 percent below where they were in 2010.
Still, Obama also notes some shortcomings in the law, and proposes plans to address them.
Obama’s call for the public option echoes Clinton’s, though Clinton goes farther in that she does not limit her proposal to certain areas and calls for the ability to buy into Medicare starting at age 55.
The moves also come at a time when Sanders has electrified much of the Democratic base through his proposal to go even further, and provide single-payer healthcare for everyone.
However, Obama notes “the importance of pragmatism in both legislation and implementation.”
“Simpler approaches to addressing our health care problems exist at both ends of the political spectrum: the single-payer model vs. government vouchers for all,” Obama writes. “Yet the nation typically reaches its greatest heights when we find common ground between the public and private good and adjust along the way.”
During the 2008 campaign, Obama praised a single-payer system, but noted that his plan was more feasible.
Asked if the White House thinks single-payer would be the best system in a perfect world, White House deputy chief of staff Kristie Canegallo did not say yes or no, but noted, “We do not live in a perfect world.”
“What he has learned, and what you see reflected in the Affordable Care Act, is a realism,” she added, noting that Obama is proposing “continuing tinkering on a foundation.”
Obama also acknowledges that some middle-class families are still having trouble affording their premiums, an area where Republicans have seized on reports of price increases.
Experts have noted that ObamaCare’s financial assistance might decline too sharply as income rises, leaving it hard for some middle class people to afford premiums. Obama proposes to increase financial assistance “to help middle-class families who have coverage but still struggle with premiums.”
Aides said that Obama is laying out the broad outlines of the policies, and details would be filled in later by future policymakers. For example, the financial assistance could help people pay out of pocket costs as well, an area of focus given that ObamaCare plans tend to have higher deductibles.
In Obama’s final year in office, his administration has ramped up a push to fight rising prescription drug prices, and the president has harsh words for the pharmaceutical industry.
He writes that he has been able to work with hospitals, “yet others, like the pharmaceutical industry, oppose any change to drug pricing, no matter how justifiable and modest, because they believe it threatens their profits.”
Obama pushes for congressional action on proposals like allowing Medicare to negotiate drug prices, which is strongly opposed by the pharmaceutical industry.
“We need to continue to tackle special interest dollars in politics,” Obama concludes.
Headline: Western Journalism