Bennet, Kaine Urge Colleagues to Support Medicare-X Choice Act to Achieve Universal Health Care

DENVER, Colo. – Sens. Michael Bennet, D-Colo., and Tim Kaine, D-Va., on Wednesday reintroduced their Medicare-X Choice Act by urging their colleagues to embrace it as a way of expanding both the Affordable Care Act and Medicare. 

During a late morning call with reporters, the senators said their Medicare Exchange – hence Medicare-X – plan would offer families, individuals and small businesses a better way to secure low-cost health insurance, while also controlling the cost of health care and increasing competition in the health insurance market. 

To illustrate, Bennet recalled a conversation he had with a small business owner in Jacksonson County, Colo., over President’s Day weekend. 

Despite both he and his wife working 50 hours a week, neither of them believes they can afford health insurance right now. They also found they can’t hire additional workers because those they’ve offered jobs said they’d have to give up their Medicaid, their sole source of health care insurance, in order to take the job. 

Bennet assured the reporters on the call they’d have no problem finding similar stories in other parts of the country. 

“The fact is …. we have millions of people who are uninsured or underinsured, and we spend twice as much on health care as any other industrialized country, for worse outcomes,” he said. 

“I think most people would agree that we need to face these issues and deal with these problems,” Bennet added. “The Affordable Care Act made an enormous difference for millions of people, it didn’t go far enough.” 

“Medicare-X is the best way to cover everyone, reduce health costs, and improve the quality of health insurance for all Americans, including those who’ve historically suffered the most from poor access to quality coverage and care,” he said, adding, “We have a responsibility to create the best health care system possible and achieve universal coverage in our country. We can do that through Medicare-X.” 

The Affordable Care Act expanded health insurance coverage to an additional 20 million Americans, established critical protections for patients with pre-existing conditions, and standardized essential health benefits for all qualified health plans. 

But the senators said Wednesday that many Americans still face high health care costs and limited options for affordable health insurance. 

Currently, 10% of counties still have only a single insurer offering health insurance in 2021, they noted. 

Kaine said two things had changed recently that will likely make it easier for Medicare-X to move forward on Capitol Hill. 

“The first is the pandemic,” he said. “With massive job losses, exacerbated health disparities, and increasing health care costs, COVID-19 underscores the urgent need for us to expand access to quality, affordable care.” 

“The second thing that’s changed is we have a new president. So instead of four more years of someone trying to sabotage health care and take it away from millions of people, President Biden is actively talking about expanding health insurance to more Americans. 

“And I think the proposal he ran on is very similar to what we’re introducing today,” he said. 

 As outlined by the senators, the bill would work within the Medicare framework to establish a Medicare Exchange public option plan in every county in America for individuals and small businesses, providing an additional, affordable option in all communities. 

It would also build on the ACA and expand premium and cost-sharing support to make all exchange options even more affordable for the uninsured. 

Under Medicare-X, the public option would initially be available on the individual exchange in areas where there is a shortage of insurers or higher health care costs due to less competition—including rural communities in Colorado and Virginia. 

By 2025, the Medicare Exchange plan would expand to every ZIP code in the country and be added as another option on the Small Business Health Options Program Marketplace. 

Medicare-X would expand Medicare’s network of doctors and providers and guarantee the essential health benefits established in the ACA, such as maternity care and mental health services. 

Medicare Exchange plans would expand benefits and provide all primary care services without cost-sharing requirements for plan holders. 

Additionally, it would ensure access to affordable prescription drugs by empowering the Secretary of Health and Human Services to negotiate drug prices for Medicare Exchange plans and the Medicare Part D program. 

The senators said the legislation also includes several updates to make coverage affordable. These include: 

• To better support rural hospitals and providers and increase access to health care for Americans living in rural communities, the proposal would allow for payment adjustments of up to 150% of Medicare fee-for-service rates. Previously, the bill allowed for payment adjustments in rural areas up to 125%. 
• On top of the essential health benefits required for qualified health plans under the ACA, Medicare Exchange plans would expand on those benefits and provide primary care services with no cost-sharing for plan holders. 
• The bill provides a larger tax premium subsidy for Americans living below 400% of the Federal Poverty Level (FPL). This would help low-income Americans access coverage by making premiums more affordable, including no premiums for those living at or below 150% of the FPL. 
• Families earning more than 400% of the FPL would be eligible for the ACA tax credit, helping more middle-income Americans afford quality health insurance. This proposal expands eligibility for the ACA’s premium tax credit to families above 400% of the FPL and makes the tax credits even more generous than in the previous iteration of the bill. 
• This proposal now fixes a glitch in the ACA that prevents family members of people who are insured through the health care exchange from receiving a tax credit. This could expand coverage to 2 to 6 million more Americans. 
• This legislation would direct the Centers for Medicare and Medicaid Services to study the impact of covering services such as long-term services and support; home- and community-based services; assistive and enabling technologies; and vision, hearing, and dental services. The study would examine the effects on benefits and the costs to beneficiaries. It would also review the implications in the health market and provide recommendations to Congress on potential inclusion of these benefits under Medicare plans. 
• This plan would help drive down costs across the entire health care industry by providing additional resources to the Department of Justice and the Federal Trade Commission to take appropriate antitrust enforcement actions and address the root causes of consolidation in the health care market. 

“We’re really excited about this,” Kaine said. “There are other good plans on the table. And they all have to be on the table as we figure out the best way to do this. But Michael and I have worked hard on this. We think it is a fairly close fit with what the administration wants. And we are excited about pushing forward on the next big step forward to make sure that Americans get health care coverage as we come out of this most devastating public health emergency in the last century.”

But of course, not everyone agrees with the senators approach.

Shortly after the press conference, the Partnership for America’s Health Care Future, an alliance of American hospital, health insurance, and pharmaceutical lobbyists, put out a statement saying the better way to go would be to improve the current health care system.

“The Partnership for America’s Health Care Future believes that every American deserves access to affordable, high-quality health coverage and care, and the best way to achieve this is to strengthen our current system – not start over by creating unaffordable, one-size-fits-all government health insurance systems like Medicare-X,” Lauren Crawford Shaver, the Partnership’s executive director, said. “Now, more than ever, we should build on and improve what’s working where private coverage, Medicare, and Medicaid work together to expand access to health coverage and care.”

The bill text is available here. A summary is available here.