Say hello to "Medicare Part E" - as in, "Medicare for Everyone."
House Democrats are looking at re-branding the public health
insurance option as Medicare, an established government healthcare
program that is better known than the public option.
The strategy could
benefit Democrats struggling to bridge the gap between liberals in
their party, who want the public option, and centrists, who are worried
it would drive private insurers out of business.
much of the public is foggy on what a public option actually is, people
understand Medicare. It also would place the new public option within
the rubric of a familiar system rather than something new and unknown.
The idea has bubbled up among House Democrats and leaders in the past week, most prominently in a caucus meeting last Thursday.
Mike Ross (D-Ark.) spoke out last week in favor of re-branding the
public option as Medicare, startling many because he has loudly
proclaimed his opposition to a public option.
Oberstar (D-Minn.), the veteran chairman of the House Transportation
Committee, also voiced his support, as did House Majority Whip James
John Schadl, a spokesman for Oberstar, explained the congressman likes the idea because people are familiar with Medicare.
of his concerns is that people don't know what a public option is.
Medicare is a public option," Schadl said. He said Oberstar started
talking about "Medicare for Everyone" during August town hall meetings.
A notable incident last summer demonstrated the popularity
of Medicare and the confusion over the public option when a man
famously told Rep. Bob Inglis (R-S.C.), "Keep your government hands off
Speaker Nancy Pelosi (D-Calif.) planned to
unveil a proposal to her caucus Tuesday night that would include the
public option favored by liberals in the healthcare bill Democrats want
to bring to the floor, according to two House sources.
plan, called the "robust" option or "Medicare Plus 5" in the jargon
that has emerged on Capitol Hill, ties provider reimbursement rates to
Medicare, adding 5 percent. Leaders are planning to roll the bill out
next week, and are hoping to vote the first week in November
Democrats say there's no need to rename a legislative concept that's
gained steadily in support since being lambasted as a "government
takeover" in August. A Washington Post-ABC poll published Tuesday
showed 57 percent of the public supports the idea - up five points
since August - while 40 percent opposes it.
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"It keeps polling
better and better as a public health insurance option," said a senior
Democratic aide. "I don't think it's changing." Polling experts,
however, have documented that many people don't know what a public
option is, and that small changes in language can cause poll results to
vary widely. An August poll by Penn, Schoen and Berland Associates
showed that only 37 percent of those polled correctly identified the
public option from a list of three choices.
"Before this year, few people had ever heard of the term ‘public option,' " Ross said last week.
not clear exactly how the new Medicare idea would work. Some want to
expand Medicare itself to uninsured people under 65. Others want to
simply rename what is now called the public health insurance option.
who supports a "single-payer" system that would be completely run by
the government, doesn't want a Medicare public option to be based on
existing Medicare rates because he believe Minnesota is one of the
states shortchanged by Medicare reimbursements.
Republicans mocked the idea of re-branding a plan they still consider a government takeover of healthcare.
"It didn't matter what
they called Crystal Pepsi; no one wanted to drink it," said Michael
Steel, spokesman for House Minority Leader John Boehner (R-Ohio). "No
matter how the Democrats ‘re-brand' their government takeover of
healthcare, the American people oppose it."
also note that Medicare is already $37 trillion in the hole and is
projected to go bankrupt by 2018. "Has anyone noticed that Medicare is
completely broke?" said Andrew Biggs, a scholar at the American
Enterprise Institute who worked in the White House on President George
W. Bush's plan to overhaul Social Security.
The public health
insurance option would be a government-run plan designed to push all
insurance premiums down by creating more competition in a business
where one or two insurers dominate many markets. The idea has gotten a
cool reception from some Senate Democrats, and Republicans are
adamantly opposed. But Pelosi has flatly stated that the House bill
will include a public option.
In a closed-door caucus meeting
last week, Ross, one of the most conservative Democrats in the House,
offered support for expanding Medicare, saying it would prevent the
need to create a new bureaucracy. He said he wasn't advocating a plan,
however, and added that the new coverage would have to have much higher
reimbursements for physicians and hospitals. He also said it would need
to compete with private insurers.
In an odd reversal, that
idea was shot down as too liberal by House Energy and Commerce
Committee Chairman Henry Waxman (D-Calif.), himself a liberal champion.
Waxman said expanding Medicare would essentially move toward a fully
government-run single-payer system, while the public option was
designed to spur competition.
People have been talking about
some sort of Medicare Part E since Congress debated the prescription
drug benefit, Medicare Part D, in 2003. In the 2004 Democratic
presidential primaries, Rep. Dennis Kucinich (D-Ohio) called his
single-payer coverage proposal "Medicare Part E."
The idea of
expanding Medicare while still keeping private insurance was proposed
in 2007 by Johns Hopkins University Professors Gerard Anderson and Hugh
Waters. They presented a paper at a forum of the Brookings Institution
advocating "Medicare Part E(veryone)," and said their proposal would
expand Medicare to ensure universal coverage while allowing people to
stay on their employers' health plans.