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THE ‘MEDICARE FOR ALL’ PRICETAG: As Elizabeth Warren’s campaign staff work out the math of raising more than $30 trillion to fund her healthcare plan, they’ll be looking at both cost-shifting and raising more revenues.
A recent Urban Institute study that examined a policy similar to what Warren and Sen. Bernie Sanders have talked about estimates that the federal government will need to spend $34 trillion more over 10 years. Not all of that is new money to the entire system. Instead, $27 trillion of that would be taking on what states, individuals, and businesses are paying now. It would still involve new taxes because the money will have to be funneled over to the federal government somehow, but it will probably be a distinction the campaign draws out as they try to sell the idea politically.
“Medicare for all,” however, is also estimated to result in more total national health spending than current law, the Urban Institute study estimates. (And that’s a conclusion that conservative fiscal expert Charles Blahous over at the Mercatus Center agrees with, even though his study has been used by single-payer advocates to suggest the opposite.) The $34 trillion would represent the federal government taking over the $27 trillion paid for elsewhere in the system today — by states and the private sector — plus an extra $7 trillion that Warren would need to find a way to raise.
It’s important to note that the $34 trillion represents the new spending the federal government takes on, in addition to what it spends now. If you add all of that up, plus another $8 trillion for the spending that will happen outside of “Medicare for all” — such as healthcare for overseas military and treatments for foreign visitors — then national health spending would grow to $59 trillion over a decade.
The battle over funding will be difficult as more details of the bill come forward, including the question over what exactly doctors and hospitals can expect to be paid under the plan. The Urban Institute estimates that doctors would be paid Medicare rates, and that hospitals would be paid a bit above that, but the Medicare for All Act doesn’t say that. Instead, it says in Sec. 401 that Health and Human Services will decide. If providers make more, the price tag rises.
The only promise Warren has made about funding is that she will not sign a healthcare bill into law that increases costs on the middle class.
But she could consider a plan that’s less generous. The Urban Institute writes that a “lite” version of “Medicare for all” would limit benefits to those covered under Obamacare, make higher-income people pay out of pocket for some of their own care, and only cover legal residents. Should Warren choose that route, the price tag for additional federal spending would drop to $17.6 trillion over a decade, bringing total national health spending lower than current law.
Obamacare is a cautionary tale about going that route. The last major health insurance expansion illustrates what a delicate balance the spending details are once lawmakers review scoring from the Congressional Budget Office. When lawmakers were writing the Affordable Care Act, they wanted to keep it at a cost below $1 trillion over a decade. To get there, they limited who would qualify for subsidies. As a result, millions of middle-class people face much higher premiums than they did before. Without a spending limit, however, Obamacare may never have passed.
Good morning and welcome to the Washington Examiner’s Daily on Healthcare! This newsletter is written by senior healthcare reporter Kimberly Leonard (@LeonardKL) and healthcare reporter Cassidy Morrison (@CassMorrison94). You can reach us with tips, calendar items, or suggestions at [email protected]. If someone forwarded you this email and you’d like to receive it regularly, you can subscribe here.
NEW YORK ARBITRATION INCREASES PATIENT HEALTHCARE COSTS: That’s according to a new report from USC-Brookings Schaeffer Initiative for Health Policy that looked at what happened in New York. It found that the arbitration model of figuring out what doctors and hospitals will get paid “substantially” increased what people paid for their healthcare. Insurers are likely to point to the study in arguing that Congress should not go this route and instead should focus on limiting what providers can charge.
OKLAHOMANS GET CLOSER TO PUTTING MEDICAID EXPANSION ON THE BALLOT: Oklahomans in favor of putting Medicaid expansion on the ballot next year collected about 313,000 signatures for their petition, surpassing the 178,000 signatures that state law requires, according to the Fairness Project.
The Associated Press reported that the signatures have been received by the Oklahoma Secretary of State for counting, and Amy Canton in the secretary’s office said they hope to finish counting them in about two weeks. Once they’re counted, opponents of the ballot measure have 10 days to appeal, and some conservative think tanks, including the Oklahoma Council of Public Affairs, are gearing up for a fight. The Oklahoma Supreme Court block OCPA’s challenge to the initiative earlier this year.
FDA WARNS VAPE COMPANY TO PULL NEARLY 100 FLAVORED VAPING PRODUCTS: The Food and Drug Administration sent a stern warning letter to New Jersey-based vaping company Eonsmoke, LLC for illegally marketing 96 flavored vaping liquids. Eonsmoke did not receive prior authorization from the FDA to sell and advertise tobacco products, or to use the claim that their products do not have the “thousands of harmful chemicals and additives often found in tobacco cigarettes.”
MASSACHUSETTS LAWMAKERS LOOK TO TREAT FOOD LIKE MEDICINE: Two Massachusetts state legislators and Harvard Law School have introduced the Massachusetts Food is Medicine State Plan to connect people on Medicaid to nutrition resources, included a customized diet to fit a patient’s health needs and vouchers, or “prescriptions,” for foods like fruits and veggies. For example, a person with a health condition that requires a specific diet as part of a treatment plan will be given medically tailored meals.
VAPING-RELATED INJURIES AND DEATH TOLL RISE: The Centers for Disease Control and Prevention reported that the number of lung-injury illnesses linked to vaping has reached 1,604 and 34 deaths have been confirmed across 24 states.
The first death linked to vaping in D.C. has been confirmed: The D.C. Department of Health confirmed Thursday that someone in the District has died of the mysterious lung injury linked to vaping, recently dubbed EVALI: e-cigarette, or vaping, product use associated lung injury.
The Rundown
Bloomberg Trump considers retreat from ban of mint, menthol vaping flavors
Kaiser Health News Los Angeles vape district a black-market gateway
Stat An Alzheimer’s patient on what was lost when Biogen shut down its trial, and what may be gained again
Atlanta Journal-Constitution Inspector General: Veterans Affairs failed to protect whistleblowers
The New York Times Scientists were hunting for the next Ebola. Now the U.S. has cut off their funding
Calendar
FRIDAY | Oct. 25
Noon. Reserve Officers Association Building. 1 Constitution Ave NE. Alliance for Health Policy congressional briefing on “Modernizing Medicare Part D.” Details
WEDNESDAY | Oct. 30
9 a.m. Bipartisan Policy Center. 1225 I St NW. Event on surprise medical billing. Details.
10 a.m. National Press Club. 529 14th St. NW. Physician organizations will call for tighter regulations on e-cigarettes. Details.
