By Jason Altmire
It’s been 10 years since former President Barack Obama initiated the discussion about America’s healthcare system, a contentious debate that culminated with the enactment of the Affordable Care Act.
Now, just a decade later, leading Democrats advocate scrapping the Affordable Care Act in favor of “Medicare for All” – which has become the litmus test for the party’s 2020 presidential candidates.
Today, more than 24 million Americans who have access to health care as a result of the Affordable Care Act’s limitation on preexisting condition exclusions, the individual marketplace, and Medicaid expansion. Since the law’s 2010 enactment, the economy has seen unprecedented growth and added tens of millions of jobs.
Clearly, the sky didn’t fall as was predicted by some ACA naysayers and in 2018 Democrats used these results to challenge Republicans who still want to repeal the law. They rode the resulting blue wave to a 40-seat gain and takeover of the House of Representatives.
So why, after their crowning policy achievement of the past half-century, do some Democrats want to discard the ACA in favor of a single-payer Medicare for All approach?
Supporters of the plan point to polling showing overwhelming support of the concept, which was pioneered by U.S. Sen. Bernie Sanders, I-Vt., and is now supported by nearly every major Democratic presidential candidate.
In a January Kaiser Family Foundation poll, 71 percent of U.S. adults (including Republicans) had a favorable opinion of Medicare for All and the guarantee of health insurance for every American.
But the fine print matters. In the same survey, 55 percent of respondents said they believed Medicare for All would allow them to keep their own insurance plans, which Sanders’ bill specifically prohibits. (Currently 180 million Americans are covered through employer-based plans that would be eliminated under Sanders’ bill).
When told Medicare for All would eliminate private insurance companies, support dropped to 37 percent. Support continued to drop as respondents were told about the higher taxes, longer wait times, and greater financial and bureaucratic burden on the Medicare program that these proposals would create.
Democrats said that their most important policy priority to be protecting the ACA, again showing a lack of understanding of single-payer proposals.
The fact is that the Medicare system cannot handle such an expansion. The Congressional Budget Office reports that Medicare spending will double over the next decade, reaching an astonishing $1.5 trillion by 2029.
In addition, the Medicare Trust Fund will be depleted by that time, according to the most recent report of its trustees.
Further complicating the issue, the most popular program among Medicare beneficiaries is Medicare Advantage, an alternative to traditional Medicare that is run through private insurers, would be eliminated under Medicare for All.
Medicare Advantage is one of the few issues that garners overwhelming bipartisan support in Congress. Attempts to limit funding for the program are routinely swatted away due to the grassroots uprising that occurs among seniors.
Rick Pollack, the president and CEO of the American Hospital Association, has sounded the alarm about what Medicare for All would mean for hospitals, noting that, “hospitals are already paid far less than the cost of caring for Medicare patients, and more patients with Medicare would strain hospitals even more, and could threaten hospitals survival.”
Despite these facts, the idea of single-payer health care is no longer a pie in the sky dream. The center of gravity of the Democratic Party has undeniably moved to the left, making issues like Medicare for All less politically toxic than would have been the case only a few years ago.
In addition, social media-savvy progressives in Congress have generated extraordinary levels of coverage, which makes their proposals more viable as Democratic candidates at all levels are cajoled into supporting policies championed by the left.
This is why voices like Pollack’s and others who can offer a reality check on what Medicare for All really means are so important.
Everyone wants a health care system that offers universal access to high-quality, affordable care. Thanks to the ACA, more Americans have that access than ever before.
Let’s be sure to look before we leap into another contentious nationwide debate and dismantle the system that millions of Americans count on every day.
Former U.S. Rep. Jason Altmire, a Democrat, represented Pennsylvania’s old 4th Congressional District, in western Pennsylvania, from 2007-2013. He is the author of “Dead Center, How Political Polarization Divided America, and What We Can Do About It”