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Journal-News: ‘Medicare-for-all’ single-payer plans reignited by GOP’s Obamacare rollback

By Barrett Newkirk and David Robinson, June 23

As Republicans push reforms reducing the government’s role in health care, some opponents are emboldened in their support for the opposite approach, one that greatly increases the government-health care link.

Progressive politicians and activists see a future in single-payer health care, the term for a government-run health insurance program that would be available to any American. While a Democratic-backed federal bill has no future in the GOP-led Congress, backers have had more success at the state level.

Republicans in the U.S. Senate on Thursday unveiled their version of plans to overhaul the Affordable Care Act. While official estimates won’t come until next week, a similar plan passed by the U.S. House was expected to leave 23 million Americans uninsured and increase out-of-pocket costs for the sick and elderly.

Long before the recent explosive health care upheaval, the single-payer torch has been carried by several New York lawmakers since the 1990s.

Assemblyman Richard Gottfried, a Democrat from Manhattan, has championed the single-payer push in New York. He described it as an example for states to expand the federal Medicare program for the elderly to the entire population.

“What is going on in Washington is making it clearer than ever that the only way Americans can get access to health care is through Medicare-for-all legislation starting in the states,” Gottfried said Thursday.

The single-payer legislation, called the New York Health Act, had passed the Democrat-led Assembly three times before 2017, but it repeatedly stalled in the Republican-leaning Senate, which represents more rural upstate New York versus the urban New York City metro area. The split, also, mirrors the U.S. political divide.

More than 100 Democrats in the U.S. House have signed on to a single-payer bill introduced by Rep. John Conyers of Michigan called Medicare for All because it would eliminate the current 65-and-over requirement for Medicare. Sen. Bernie Sanders of Vermont has talked about introducing his own plan.

Still, debate over federal health care law this year prompted a renewed push to pass the New York Health Act, but once again it passed the state Assembly only to die in the Senate. The legislative session adjourned this week.

Dr. Oliver Fein is the chair of the New York metro chapter of Physicians for a National Health Program, a single-payer advocacy group. On Thursday he focused on Republican-led efforts to cut funding for Medicaid, the joint state-federal health program for millions of poor and disabled.

“That is likely to be a huge destabilizing factor not just for the patients themselves, the people who will be denied coverage, but frankly for the whole hospital system because hospitals really do depend on Medicaid income,” Fein said.

Both Fein and Gottfried spoke about Congress’ plans to overhaul health care in terms of re-energizing efforts for single-payer, despite opponents questioning how states would overcome cost and logistical hurdles.

New York’s single-payer plan calls for income-based tax increases to pay for expanding state-run health coverage, with the wealthy shouldering a larger percentage of the cost.

While the single-payer tax increases have drawn criticism, lawmakers, hospital leaders and voters have held numerous rallies in New York to voice concerns about how proposed cuts to Medicaid could leave the state with a major budget hole.

Gottfried pointed to the mounting opposition to Congress’ push to overhaul health care as potentially being the long-awaited catalyst needed to enact single-payer plans.

“Whatever the Republicans in Washington do is going to take billions of dollars out of health care in New York State, and the only way New York can afford to fill those gaps and protect ourselves is with the New York Health Act,” Gottfried said.

Gov. Andrew Cuomo, a Democrat, has criticized Congress’ plans for overhauling health care but hasn’t indicated what his position is on single-payer.

Besides New York, some community leaders in California have joined the single-payer fray over the past year.

Following the election of President Trump, Jimmi Kuehn-Boldt of Palm Springs began advocating for single-payer health care with the grassroots group Courageous Resistance. At 63, he doesn’t expect anything to take effect before he’s eligible for Medicare in a little over a year, but he said he’s worried about seeing care for others deteriorate if Republicans are successful.

The Senate proposal makes any talk of single-payer, either in Washington or Sacramento, “just as important, if not more than before,” Kuehn-Boldt said.

“We’ve got to see how it’s fleshed out in Washington, but we can still move forward here,” he added.

State senators in California, where Democrats hold strong majorities and the governorship, approved a bill June 1 aimed at creating a health plan to cover every state resident. It must now pass an Assembly committee by mid July in order to stay alive.

The plan would provide broad coverage, including the essential health benefits spelled out in the Affordable Care Act. The bill says enrollees would not pay co-payments or deductibles.

State Sen. Toni Atkins of San Diego, one of two Democratic sponsors of the bill, has said that even if the Affordable Care Act remains intact, the state can do more to cut costs and improve access.

Atkins issued a statement Thursday calling the U.S. Senate health bill more than mean, as Trump has reportedly called it, but “simply wrong.”

“We will continue to demand the quality healthcare we all deserve,” Atkins said. “If Congress passes this bait-and-switch, we will fight here at home to ensure that Californians remain covered.”

Price remains a major question for California’s plan and has made the bill a non-starter for some Republican lawmakers. A recent estimate put the cost at $400 billion annually with half of that needing to come from new revenue.

Gov. Jerry Brown, a Democrat who also roundly criticized congressional Republicans on Thursday, has not said if he would sign a single-payer health plan into law.