{"id":272818,"date":"2020-10-24T02:54:21","date_gmt":"2020-10-24T06:54:21","guid":{"rendered":"https:\/\/canadianinquirer.net\/v1\/?p=272818"},"modified":"2020-10-24T02:54:21","modified_gmt":"2020-10-24T06:54:21","slug":"did-trump-confuse-the-public-option-with-medicare-for-all","status":"publish","type":"post","link":"https:\/\/canadianinquirer.net\/v1\/2020\/10\/24\/did-trump-confuse-the-public-option-with-medicare-for-all\/","title":{"rendered":"Did Trump Confuse the Public Option With \u2018Medicare for All\u2019?"},"content":{"rendered":"
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The Trump campaign did not respond to our request asking where the evidence for this claim came from. Experts called it a distortion of Biden\u2019s plan. (File photo: Charles Deluvio\/Unsplash)<\/figcaption><\/figure>\n<\/div>\n

During the final presidential debate, President Donald Trump claimed that 180 million people would lose their private health insurance to socialized medicine if the Democratic presidential nominee, former Vice President Joe Biden, is elected president.<\/p>\n

\u201cThey have 180 million people, families under what he wants to do, which will basically be socialized medicine \u2014 you won\u2019t even have a choice \u2014 they want to terminate 180 million plans,\u201d said Trump<\/a>.<\/p>\n

Trump has repeated this claim<\/a> throughout the week, and we thought the linkage of Biden\u2019s proposed health care plan with socialism was something we needed to check out. Especially since Biden opposed \u201cMedicare for All,\u201d the proposal by Sen. Bernie Sanders (I-Vt.) that would have created a single-payer health system run completely by the federal government, and has long been attacked by Republicans as \u201csocialist.\u201d<\/p>\n

The Trump campaign did not respond to our request asking where the evidence for this claim came from. Experts called it a distortion of Biden\u2019s plan.<\/p>\n

Where the Number Comes From<\/b><\/p>\n

Experts agreed the number of people who have private health insurance either through an employer-sponsored plan or purchased on the Affordable Care Act\u2019s health insurance marketplace is around 180 million people.<\/p>\n

KFF, a nonpartisan health policy organization, estimated in 2018<\/a> that about 157 million Americans had health insurance through their employer, while almost 20 million had insurance they purchased for themselves. Together, that adds up to about 177 million with private health insurance. (KHN is an editorially independent program of KFF.)<\/p>\n

What Does Biden Support? <\/b><\/p>\n

Biden supports expanding the ACA through several measures, including a public option. Under his plan, this public option would be a health insurance plan run by the federal government that would be offered alongside other private health insurance plans on the insurance marketplace.<\/p>\n

\u201cThe marketplace is made up of multiple insurers in areas,\u201d said Linda Blumberg<\/a>, a health policy fellow at the Urban Institute. \u201cSometimes there are five or more [plans]; sometimes there is only one. Biden is talking about adding a public option in the marketplace. You could pick between these private insurers or you could pick the public option.\u201d<\/p>\n

Getting rid of the so-called employer firewall is also part of Biden\u2019s proposal.<\/p>\n

This firewall was implemented during the rollout of the ACA. It was designed to maintain balance in the insurance risk pools by preventing too many healthy people who have work-based coverage from opting instead to move to a marketplace plan. And it all came down to who qualified for the subsidies that made these plans more affordable.<\/p>\n

Currently, those who are offered a health insurance plan through their employer that meets certain minimum federal standards aren\u2019t eligible to receive these subsidies, which come in the form of tax credits. But that leaves many low-income workers with health care plans that aren\u2019t as affordable or comprehensive as marketplace plans.<\/p>\n

Biden\u2019s plan would eliminate that firewall, meaning anyone could choose to get health insurance either through their employer or through the marketplace. That\u2019s where many Republicans argue that we could start to see leakage from private health insurance plans to the public option.<\/p>\n

\u201cThe problem is healthy people leaving employer plans,\u201d said Joseph Antos<\/a>, a scholar in health care at the conservative-leaning American Enterprise Institute. That could mean the entire workplace plan\u2019s premiums would go up. \u201cYou could easily imagine a plan where it spirals, the premiums go up, and then even more people start leaving the plans to go to the public option.\u201d<\/p>\n

Blumberg, though, said that because the marketplace would still include private health insurance plans alongside the public option, it doesn\u2019t mean everyone who chooses to leave their employer plan would go straight to the public option.<\/p>\n

She has done estimates<\/a> based on a plan similar to the one Biden is proposing. She estimates that only about 10% to 12% of Americans would choose to leave their employer-sponsored plans, which translates to about 15 million to 18 million Americans.<\/p>\n

KFF also did an estimate<\/a> and found that 12.3 million people with employer coverage could save money by buying on the exchange under the Biden plan.<\/p>\n

But \u201cit\u2019s not clear all of those people would choose to leave their employer coverage, though, as there are other reasons besides costs that people might want to have job-based insurance,\u201d Cynthia Cox<\/a>, vice president and director of the program on the ACA at KFF, wrote in an email.<\/p>\n

Either way, none of the estimates are anywhere close to the 180 million that Trump claimed.<\/p>\n

Is This Type of Public Option Socialism? <\/b><\/p>\n

Overall, experts said no, what Biden supports isn\u2019t socialized medicine.<\/p>\n

\u201cSocialized medicine means that the government runs hospitals and employs doctors, and that is not part of Biden\u2019s plan,\u201d Larry Levitt<\/a>, executive vice president for health policy at KFF, wrote in an email. \u201cUnder Biden\u2019s plans, doctors and hospitals would remain in the private sector just like they are today.\u201d<\/p>\n

However, Antos said that, in his view, the definition of socialism can really vary when it comes to health care.<\/p>\n

\u201cI would argue in one sense, we would already have socialized medicine. We have massive federal subsidies for everybody, so in that sense, we\u2019re already there,\u201d said Antos. \u201cBut, if socialized medicine means the government is going to dictate how doctors practice or how health care is delivered, we are obviously not in that situation. I don\u2019t think the Biden plan would lead you that way.\u201d<\/p>\n

And in the end, Antos said, invoking socialism is a scare tactic that politicians have been using for years.<\/p>\n

\u201cIt\u2019s just a political slur,\u201d said Antos. \u201cIt\u2019s meant to inflame the emotions of those who will vote for Trump and meant to annoy the people who will vote for Biden.\u201d<\/p>\n

Our Ruling <\/b><\/p>\n

Trump said 180 million people would lose their private health insurance plans to socialized medicine under Biden.<\/p>\n

While about 180 million people do have private health insurance, there is no evidence that all of them would lose their private plans if Biden were elected president.<\/p>\n

Biden supports implementing a public option on the health insurance marketplace. It would exist alongside private health insurance plans, and Americans would have the option to buy either the private plan or the public plan. While estimates show that a number of Americans would likely leave their employer-sponsored coverage for the public plan, they would be doing that by choice and the estimates are nowhere near Trump\u2019s 180 million figure.<\/p>\n

Experts also agree that the public option is not socialized medicine, and it\u2019s ridiculous to conflate Biden\u2019s plan with Medicare for All.<\/p>\n

We rate this claim Pants on Fire.<\/p>\n

Kaiser Health News<\/a> (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation<\/a> which is not affiliated with Kaiser Permanente.<\/em><\/p>\n

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