Congressmen Bryan Schatz has proposed a plan for states that want to to let people buy into Medicaid, which would be sort of a public option.
My own thoughts are that in principle this is a pretty good idea, although I don’t like his idea to raise Medicaid rates to Medicare level. I have two reasons to want Medicaid to keep the lower reimbursements to providers, aside from the obvious, the cost:
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Medicaid functions decently despite the low rates. If we want to get serious about holding down costs, we need to keep them where they are.
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Once you have a public option, the primary purpose of private insurance as competition would be to provide better care at higher cost. Schatz’s plan doesn’t really have Medicaid compete with private insurers so much as establish a value niche in the market. Cheaper insurance, presumably a less attractive provider network, vs. more expensive insurance and better providers. I don’t mind public vs. private competition, except that if we’re going to do that I’d rather see a seperate public option do the competing, a program that can be killed if it loses.
But overall it’s not a bad idea if we’re keeping ACA. Thoughts?