Democrats see springboard for health care in high court win

WASHINGTON (AP) – With the Affordable Care Act now secured under the country’s health programs, Democrats are eager to jump beyond that.

They want to expand coverage for people of working age and their families, add new benefits to Medicare for the elderly, and reduce prescription drug costs for patients and taxpayers.

But healthcare is expensive, there are shortcomings concerns and with Democrats holding a slim majority in Congress, expectations seem likely to decline later this year.

Right now, the Democrats are enjoying Thursday’s Supreme Court ruling, which upheld Obamacare for the third time in a decade. The recent challenge to the law has been viewed as drawn-out by many legal experts, but a 7-2 vote by the Conservative Court was unexpected.

“I think the Democrats know once again that they have a moment in time and they want to make the most of it,” said Kathleen Sebelius, Secretary of Health under President Barack Obama, during the passage and implementation of the Health Bill. “I think people are excited and ready to go.”

There is no shortage of suggestions. Some, like Medicare’s authorization to negotiate prescription drug prices, could save hundreds of billions of dollars depending on the structure. But coverage and benefit extensions could cost the same or even more.

Complex budgetary procedures that the Democrats use to see President Joe Biden’s domestic agenda passed by a simple majority in the Senate can also limit the types of proposals that can be considered.

“There is a sorting going on,” said John McDonough, who was a senior Senate Democrat adviser during the health bill debate. “Not all of these ideas are viable, but you don’t always know which ones are at the beginning.” McDonough is now a professor at the Harvard TH Chan School of Public Health.

The Democrats’ ideas fall under two broad headings: expanding coverage and benefits through public programs like Medicare and the Obama Act, and using government power to curb prescription drug prices. In theory, savings on prescription drugs can finance the program expansions without increasing the deficit or increasing taxes.

“These are not proposals in the single-digit billion range,” said Marc Goldwein, Senior Policy Director in the Committee for a Responsible Federal Budget. “We’re talking about $ 100 billion, $ 200 billion or more – but in different directions. The more they save, the more they can spend. ”His group advocates a reduction in government deficits, and Goldwein adds,“ I hope you stick to the basic rule that you pay for what you want to spend. ”

A hierarchy of proposals developed early on.

At the top of the list is Biden’s plan to permanently expand the more generous HealthCare.gov insurance subsidies. They will now be made available until the end of next year under his COVID-19 Aid Act. The price is estimated at $ 163 billion over 10 years.

Another public health issue is figuring out how to cover more than 2 million low-income people in mostly southern states who have not expanded their Medicaid programs. A federal solution isn’t just about pumping more money over obscure legal issues related to Medicaid.

Also uncertain are the prospects for Medicare’s approval to negotiate prescription drug prices.

House Speaker Nancy Pelosi, D-California passed robust bill in the House of Representatives nearly two years ago, and the issue remains a priority for Democrats in Congress as well as Biden. The 2019 bill would have saved the government more than $ 450 billion through Medicare price negotiations over 10 years, but Pelosi’s tough stance on the politically powerful pharmaceutical industry is seen as a problem for some Senate Democrats.

The catch is, without huge savings from prescription drugs, it will make other parts of the health agenda harder to meet. For example, adding dental, visual, and hearing services to Medicare could cost approximately $ 360 billion over 10 years.

Some ideas that inspire progressive Democrats may have the hardest time getting through the weeding process.

This could be the case with the proposal for a new health insurance plan with a “public option” to be offered alongside subsidized private coverage through HealthCare.gov. It’s not clear if such a proposal can stand under the budget rules that would allow the Biden agenda to settle the Senate without Republican votes.

Regardless, a proposal to lower the Medicare Eligibility Age to 60 from 65 could prove difficult. Republicans are already pointing out that Medicare’s huge trust fund is expected to be in the red in 2026. They say that adding more people to the program would only weaken it further. Democrats may not want to be drawn into a debate about Medicare’s solvency.

“Health care was a democratic issue from the start,” said Gail Wilensky, a Republican advisor and former Medicare administrator, health economist. “The focus is currently still on expansion. How they pay is not clear. “

Ricardo Alonso-zaldivar, The Associated Press

source https://dailyhealthynews.ca/democrats-see-springboard-for-health-care-in-high-court-win/