Where is the debate on the reform of health insurance? • forbes.com

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As a result of the Republicans' failure to repeal and replace Obamacare and the Democratic House Takeover, where does the health care debate go from now?

No important health care law will come out of this blocked Congress. But the 2020 presidential campaign will produce at least one democratic health plan from the nomination process.

Yes, Democrats in the House will hold a number of for-show votes on health care over the next two years – but they know that none of them can go anywhere until you reach ############################################################### 39 that they can win both the Senate and the White House.

The 2018 election brought a number of Democrats to call for a single-payer Canadian-style plan. Two-thirds of the House's new Democrat students supported the single-payer system in the November election of 26 new members. This is in addition to the 123 members of the House of the last Congress who supported it, bringing the total to 149 – a majority in the House is 218. Sixteen Democrat Senators have also supported the Pay Plan. unique Sanders at the last Congress.

But Speaker of the House of Representatives Nancy Pelosi has made it clear that she will not lead Democrats in such a controversial direction, at least over the next two years. She remembers well the electoral damage that the program Obamacare caused to the Democrats after its adoption.

Instead, she said that the House will be working to improve Obamacare for the time being.

Getty

Pelosi understands that setting up single payer health insurance plans is a popular idea among its base. A November Gallup poll found that 65% of Democrats were in favor of some kind of government plan. But only 40% of all voters support a plan run by the government.

So, Democratic leaders must walk a tightrope – please base that usually promotes a government-run plan without alienating the general electorate that does not.

But Democrats can boast of the same Gallup poll that 57 percent of voters believe the government should play a role in ensuring health insurance for citizens.

Pelosi seems to understand that single-payer health care has the potential to turn into a policy bed for Democrats.

In 2016, the left-wing Urban Institute evaluated Bernie Sanders' proposal for Medicare-for-All, which would group all Americans into one government plan. They found that his plan would be:

  • Increase national health expenditures by $ 6.6 trillion between 2016 and 2026.
  • Increase federal spending by $ 32 trillion from 2017 to 2026.
  • Sanders' proposal would increase taxes by $ 15.3 trillion between 2017 and 2026, compared to an estimated $ 32 billion by the federal government over the same period. The proposed taxes are therefore far too low to fully finance his plan. . "

In fact, Pelosi seems to be content to improve Obamacare in the interval between the resumption of the House and the 2020 elections, where a more complete proposal will emerge from the eventual Democratic candidate. This will probably lead the Democrats to focus on two proposals related to Obamacare for the moment:

  1. Improving insurance exchange subsidies for the middle class in the market for individuals facing astronomical problems unsubsidized premiums and deductibles. Forty percent of individuals in the individual market earn too much money for any Obamacare grant.
  2. Protecting reforms from pre-existing conditions allowed Republicans to seek to undermine what they wanted to undermine during their repeal and replace the debate.

These two points of focus would be a political winner / winner for the Democrats. They stand out of the political pound that excessive treatment could produce in health care while focusing on the middle-class voters to whom Obamacare's huge bonuses have hurt, while protecting universally popular medical underwriting reforms.

The Democrat-controlled House may well pass laws along these lines, but they will not go anywhere in the Republican-controlled Senate. But this is not the reason the Democrats in the House have focused on improving Obamacare: they are doing it so that the health policy advocated by the Republicans is unbalanced in the run-up to the 2020 elections.

I do not expect the other very serious Democratic presidential candidates to subscribe to the single-payer Sanders plan either. Instead, I think most of them will position themselves to look more moderate than Sanders. In most other cases, I would look for more incremental proposals from a range of choices, including:

  • The government directly negotiates drug prices.
  • Guaranteed insurability for all with democrats who oppose the alternative market, the Trump administration now relies on concepts such as short-term plans that do not cover pre-existing conditions.
  • Improved Obamacare grants – especially for the middle class who have often been forced to give up their individual insurance for reasons of affordability.
  • The return of Medicare-type public option proposals for Obamacare insurance scholarships.
  • Medicare buy-in for 50 years and older.
  • Medicare Advantage-For-All – Based on similar proposals from the Center for American Progress and the Urban Institute, which would generally combine all insurance except employer insurances into a giant federal program offering people the choice of Medicare, or what we now know as Medicare Advantage private plans.

That brings us to the Republicans.

Following their floggings in the 2018 elections – largely because of their disastrous treatment of repeal and replacement – what will be their health care plan for 2020?

I have no idea – and apparently they are not.

It's hard for me to see how Republicans will be able to band together around a convincing health care platform as a result of their repeal and replace the fiasco, with Trump in the lead.

I do not even know where the Republicans will start and who could take the lead.

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As a result of the Republicans' failure to repeal and replace Obamacare and the Democratic House Takeover, where does the health care debate go from now?

No important health care law will come out of this blocked Congress. But the 2020 presidential campaign will produce at least one democratic health plan from the nomination process.

Yes, Democrats in the House will hold a number of for-show votes on health care over the next two years – but they know that none of them can go anywhere until you reach ############################################################### 39 that they can win both the Senate and the White House.

The 2018 election brought a number of Democrats to call for a single-payer Canadian-style plan. Two-thirds of the House's new Democrat students supported the single-payer system in the November election of 26 new members. This is in addition to the 123 members of the House of the last Congress who supported it, bringing the total to 149 – a majority in the House is 218. Sixteen Democrat Senators have also supported the Pay Plan. unique Sanders at the last Congress.

But Speaker of the House of Representatives Nancy Pelosi has made it clear that she will not lead Democrats in such a controversial direction, at least over the next two years. She remembers well the electoral damage that the program Obamacare caused to the Democrats after its adoption.

Instead, she said that the House will be working to improve Obamacare for the time being.

Pelosi understands that setting up single payer health insurance plans is a popular idea among its base. A November Gallup poll found that 65% of Democrats were in favor of some kind of government plan. But only 40% of all voters support a plan run by the government.

So, Democratic leaders must walk a tightrope – please base that usually promotes a government-run plan without alienating the general electorate that does not.

But Democrats can boast of the same Gallup poll that 57 percent of voters believe the government should play a role in ensuring health insurance for citizens.

Pelosi seems to understand that single-payer health care has the potential to turn into a policy bed for Democrats.

In 2016, the left-wing Urban Institute evaluated Bernie Sanders' proposal for Medicare-for-All, which would group all Americans into one government plan. They found that his plan would be:

  • Increase national health expenditures by $ 6.6 trillion between 2016 and 2026.
  • Increase federal spending by $ 32 trillion from 2017 to 2026.
  • Sanders' proposal would increase taxes by $ 15.3 trillion between 2017 and 2026, compared to an estimated $ 32 billion by the federal government over the same period. The proposed taxes are therefore far too low to fully finance his plan. . "

In fact, Pelosi seems to be content to improve Obamacare in the interval between the resumption of the House and the 2020 elections, where a more complete proposal will emerge from the eventual Democratic candidate. This will probably lead the Democrats to focus on two proposals related to Obamacare for the moment:

  1. Improving insurance exchange subsidies for the middle class in the market for individuals facing astronomical problems unsubsidized premiums and deductibles. Forty percent of individuals in the individual market earn too much money for any Obamacare grant.
  2. Protecting reforms from pre-existing conditions allowed Republicans to seek to undermine what they wanted to undermine during their repeal and replace the debate.

These two points of focus would be a political winner / winner for the Democrats. They stand out of the political pound that excessive treatment could produce in health care while focusing on the middle-class voters to whom Obamacare's huge bonuses have hurt, while protecting universally popular medical underwriting reforms.

The Democrat-controlled House may well pass laws along these lines, but they will not go anywhere in the Republican-controlled Senate. But this is not the reason the Democrats in the House have focused on improving Obamacare: they are doing it so that the health policy advocated by the Republicans is unbalanced in the run-up to the 2020 elections.

I do not expect the other very serious Democratic presidential candidates to subscribe to the single-payer Sanders plan either. Instead, I think most of them will position themselves to look more moderate than Sanders. In most other cases, I would look for more incremental proposals from a range of choices, including:

  • The government directly negotiates drug prices.
  • Guaranteed insurability for all with democrats who oppose the alternative market, the Trump administration now relies on concepts such as short-term plans that do not cover pre-existing conditions.
  • Improved Obamacare grants – especially for the middle class who have often been forced to give up their individual insurance for reasons of affordability.
  • The return of Medicare-type public option proposals for Obamacare insurance scholarships.
  • Medicare buy-in for 50 years and older.
  • Medicare Advantage-For-All – Based on similar proposals from the Center for American Progress and the Urban Institute, which would generally combine all insurance except employer insurances into a giant federal program offering people the choice of Medicare, or what we now know as Medicare Advantage private plans.

That brings us to the Republicans.

Following their floggings in the 2018 elections – largely because of their disastrous treatment of repeal and replacement – what will be their health care plan for 2020?

I have no idea – and apparently they are not.

It's hard for me to see how Republicans will be able to band together around a convincing health care platform as a result of their repeal and replace the fiasco, with Trump in the lead.

I do not even know where the Republicans will start and who could take the lead.