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The X-factor in Medicare-X

April 5, 2019 12:01 am

Getting caught with inadequate health insurance, or worse, no health-care coverage at all, is a frightening and costly experience. It’s the epic equivalent of coming up a dollar short in a busy grocery store check-out line and you’ve left your credit card at home.

So, we understand U.S. Rep. Antonio Delgado giving his universal health-care option, known as the Medicare-X Choice Act, a full-court press in Congress. If enacted, the bill would create a public-option health plan for purchase on individual and small business exchanges.

We understand residents of rural communities with a handful of doctors and low incomes have asked about the health care crisis and what can be done about increasing prescription drug costs, rising premiums, rising deductibles and an overall lack of quality care.

What they may not know is that Delgado’s proposal hews closely to one released last December by the Urban Institute, an independent research group, according to a Washington Post Wire Service report.

The Institute’s proposal would get the nation to near-universal health-care coverage and relieve many of the financial burdens some people face under the current system and cost the federal treasury far less than more radical plans, according to the Post report.

Under the Institute’s proposal, Medicare and the employer-based health-care system, whereby most Americans get their insurance, would be left in place. But it would create a new health-care marketplace for most everyone else, including those on Medicaid and the Children’s Health Insurance Program, which are government initiatives for low-­income people, and those buying insurance on their own in the individual market, according to the Post story.

Under Delgado’s proposed legislation, Medicare physician networks and reimbursement rates are combined with coverage standards from the Affordable Care Act, or Obamacare, such as protections for pre-existing conditions, thereby providing a new public option available to people of all ages. Delgado’s bill would also enable workers with employer-provided insurance to maintain their coverage.

Delgado’s plan offers an affordable option that would reduce costs by capitalizing on the existing Medicare model. Because the cost of administering Medicare is lower than the cost of administering private insurance claims, Delgado said, there will be built-in cost savings passed down to individuals relying on it, Delgado said.

Delgado, who ran for the 19th Congressional District seat as a cross between a plain speaker and a policy wonk, must know that his proposal looks good on paper, as does the Urban Institute’s plan.

But, as they say in sports, they don’t play the games on paper. Delgado’s plan is impressive, but its weakness is that old standby: Who pays for it? That’s the X-factor in Medicare-X.