Senators introduce public option bill, Medicare-X: 5 things to know

Sens. Michael Bennet, D-Colo., and Tim Kaine, D-Va., introduced a bill Wednesday that would add a public option to the ACA exchanges, providing a lifeline to rural areas where all or nearly all commercial payers have dropped out.

Here are five things to know about the bill.

1. The bill, called the Medicare-X Choice Act, would essentially extend Medicare to nonelderly Americans. Medicare-X plans would mimic the private options available on the ACA's exchanges in terms of essential health benefits, including maternity, newborn and pediatric care. Patients with Medicare-X would see physicians in Medicare's provider network. Premium tax credits would be available for low-income enrollees. Medicare-X enrollees would be permitted to enroll in Part D drug coverage, and the bill would authorize HHS to negotiate drug prices.

2. Medicare-X providers would be reimbursed at Medicare rates. If passed, HHS would be required to enroll more providers, such as pediatricians and gynecologists, in Medicare. Providers in rural areas could be reimbursed up to 125 percent of Medicare rates.

3. The plan would have a staggered rollout, focusing first on rural areas. The plan would launch in 2020 in counties with one or no plans offered on the exchange. In the third year of Medicare-X, the option would be made available everywhere. In 2024, Medicare-X would be added to the Small Business Health Options Program exchange.

4. The plan is different from the Medicare-for-All bill proposed by Sen. Bernie Sanders, I-Vt. The significant difference with Medicare-X is it builds on existing legislation, rather than upending the entire system, according to a report from The Washington Post. Instead of a single-payer system, Medicare-X more closely aligns with a public option passed by the House in 2009 and 2010 that failed to gain support in the Senate. While this could discourage far-left senators from endorsing the plan, Mr. Bennet and Mr. Kaine hope the additive nature of the bill will drum up more bipartisan support, according to report.

5. The draft bill follows a bipartisan deal to help stabilize the ACA after President Donald Trump ended cost-sharing reductions last week. Sens. Lamar Alexander, R-Tenn., and Patty Murray, D-Wash., announced an agreement Tuesday to restore cost-sharing reductions and provide more flexibility to ACA innovation waivers, a deal both Mr. Bennet and Mr. Kaine have voiced support for, according to The Washington Post. Medicare-X is being billed as the next step after stabilizing the law.

Read a summary of the Medicare-X Choice Act here. Access the full text of the draft bill here.

 

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