Regulatory Policy

Bernie’s Not-So-Subtle Single-Payer Plot

Budget Committee Chairman Sen. Bernie Sanders during a Senate Budget Committee’s hearing to examine President Biden’s proposed budget request for fiscal year 2022, June 8, 2021. (Shawn Thew/Pool via Reuters)
The Democrats’ spending proposal would dramatically expand the number of Americans on government health insurance.

Senator Bernie Sanders (I.,Vt.), America’s most prominent proponent of government-run health care, is once again leading the charge to move our country to a single-payer system.

As chairman of the Senate Budget Committee, Sanders is pushing a $3.5 trillion budget plan that includes expansions of Medicare, Medicaid, and Obamacare. Some moderate Democrats have balked at the cost. But Sanders predicted Sunday that Democrats would “come together” to pass the massive package via reconciliation later this year.

The health-care reforms in the budget would funnel millions more Americans into public health coverage and put our nation a stone’s throw from Senator Sanders’s longtime goal: a government takeover of the health-care system.

Consider the Democrats’ proposed changes to Obamacare. As a part of its March coronavirus-relief package, Congress made federal subsidies for exchange plans more generous and opened them up to all enrollees for two years. Previously, only people making less than 400 percent of the poverty line — about $106,000 for a family of four — were eligible. Now, no enrollee has to pay more than 8.5 percent of their income in premiums.

The Congressional Budget Office estimates that this two-year expansion will cost taxpayers roughly $34 billion.

Now Democrats want to extend them indefinitely as part of the budget-reconciliation package at an estimated cost of $200 billion a year.

Making that change permanent would likely drive more Americans to the exchanges. Thanks in part to the more generous subsidies, the number of Americans enrolled in Obamacare plans has reached a record high of 12.2 million.

It’d be shocking if paying people to sign up didn’t result in more Americans selecting these plans.

Unfortunately, those plans tend to be of low quality. More than 70 percent of Obamacare plans have narrow provider networks, according to an analysis from health-care consultancy Avalere.

Democrats also want to make more older adults dependent on government for health care by reducing the eligibility age for Medicare from 65 to 60. That could add 20 million people to the program and cost up to $100 billion every year, according to a recent Harvard analysis.

This age group is least in need of a federal handout. More than 90 percent of those between 60 and 65 already have insurance. One recent analysis found that the low-income Americans the reform is intended to help could actually pay more under Medicare than they currently do, given that many qualify for subsidized plans under Obamacare.

In addition, the budget-reconciliation package aims to expand public coverage for low-income Americans. Already, about 75 million people get coverage through Medicaid. Democrats want to create a federally funded, Medicaid-like “public option” plan for the 4.4 million people who would be eligible for the program under the terms of Obamacare but live in one of the twelve states that have declined to expand their programs.

Combined with enrollees in the Children’s Health Insurance Program, that could increase Medicaid’s total enrollment to over 87 million. That’s more than one quarter of the entire U.S. population.

Add up all those covered by expanded versions of Medicare and Medicaid, federally subsidized exchange plans, and health plans for the military and federal employees, and suddenly we’re not far from a health-care system in which the government is the dominant provider of coverage.

To understand the problems that such a system would create, look no further than my native Canada, where the government has a monopoly on paying for all essential care. In 2020, the median wait time to receive treatment from a specialist after referral by a general practitioner was more than 22 weeks.

These long wait times can have fatal consequences. Over 10,000 Canadian patients died while waiting for procedures and specialty treatment between 2019 and 2020, according to data from the Saskatchewan-based think tank SecondStreet.org.

The story is similar in the United Kingdom’s government-run National Health Service. Some 5.6 million Brits are currently waiting for treatment — a record.

Shifting ever more Americans into publicly funded health plans, as the Democrats’ reconciliation package would, is a step toward single-payer health care. That should be deeply concerning to all of us.

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