Can “Medicaid For All” Save Obamacare?

Zach D Roberts/NurPhoto via ZUMA

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Hawaii Sen. Brian Schatz says there’s been a silver lining to Republican attempts to repeal Obamacare:

“One of the unintended consequences of the Republicans trying to cut Medicaid is they made Medicaid really popular,” Sen. Schatz said in an interview. “This conversation has shifted. There was a time where Medicare was really popular and Medicaid was slightly less popular. What this ACA battle did was make both of them almost equally popular.”

Schatz wants to take advantage of that by allowing states to add a Medicaid option to Obamacare’s exchanges. However, his proposed legislation also does this:

The Schatz bill would also raise Medicaid’s payment rates to doctors and hospitals to match those of the Medicare program. Currently, the Medicaid prices are 72 percent of those that Medicare pays — which in turn pays less than private insurers. Raising Medicaid prices to be equal would likely lure more doctors to participate in the program — but also make Medicaid (and the premiums to buy into Medicaid) significantly more expensive.

Yes, this would raise the cost of Medicaid a lot. It would also—I think—make Medicaid a more generous program than Medicare. Even liberal states like my home state of California probably wouldn’t buy into Schatz’s program under these circumstances. It’s just too expensive. We spend about $40 billion on Medi-Cal, and upping reimbursement rates to Medicare levels would probably cost something on the order of $10-15 billion. In a state budget where bitter fights break out over health care costs of $500 million, this is a nonstarter.

I suspect a smarter approach would be to raise Medicaid reimbursement rates slightly. Maybe to 75 percent of Medicare. And then work on raising them again a few years from now. Realistically, it’s hard to see any other way to get states to buy into this idea.

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is the first thing despots go after. An unwavering commitment to it is probably what draws you to Mother Jones' journalism. And as we're seeing in the US and the world around, authoritarians seek to poison the discourse and the way we relate to each other because they can't stand people coming together around a shared sense of the truth—it's a huge threat to them.

Which is also a pretty great way to describe Mother Jones' mission: People coming together around the truth to hold power accountable.

And right now, we need to raise about $400,000 from our online readers over the next two months to hit our annual goal and make good on that mission. Read more about the information war we find ourselves in and how people-powered, independent reporting can and must rise to the challenge—and please support our team's truth-telling journalism with a donation if you can right now.

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