Hillary Clinton reaffirmed her support on Saturday for creating a “public option” within Obamacare and allowing people to enroll in Medicare at age 55.
The presumptive Democratic presidential nominee also called for a substantial increase in funding in medical clinics that serve low-income Americans, fully embracing a proposal from Sen. Bernie Sanders (I-Vt.).
While Clinton has long supported the creation of new government-run insurance options and reiterated that support several times this year, Saturday’s statement comes three days before she is scheduled to make her first joint campaign appearance with Sanders ― who has championed government-run insurance and federally financed clinics throughout his career and during his own bid for the presidency.
Sanders, who ran a surprisingly strong but ultimately unsuccessful campaign for the Democratic nomination, is expected to endorse Clinton at that Tuesday event. Saturday’s announcement on health policy follows a similar one from Clinton earlier in the week, that she was enhancing her own proposal on college tuition assistance to match the considerably more generous version Sanders had sketched out.
In describing the proposals to The Huffington Post, senior Clinton campaign aides noted that Sanders had championed these ideas ― and, in particular, that the former Secretary of State’s funding proposal for the clinics matched one that the independent senator had made.
“Already, the Affordable Care Act has expanded coverage to 20 million Americans.”
“We have more work to do to finish our long fight to provide universal, quality, affordable health care to everyone in America,” Clinton said in a press release that the campaign circulated late Saturday morning. “Already, the Affordable Care Act has expanded coverage to 20 million Americans. As president, I will make sure Republicans never succeed in their attempts to strip away their care and that the remaining uninsured should be able to get the affordable coverage they need to stay healthy.”
Sanders said in a conference call shortly afterwards that the announcement was the product of discussion between the two campaigns. He praised Clinton’s proposal in strong, unambiguous terms ― describing it as “an extremely important initiative” and predicting that “it will save lives, it will ease suffering, it will improve health care in America, and it will cut health care costs.”
The idea of the public option ― as first sketched out by Jacob Hacker, a Yale political scientist ― is to create a separate, government-run insurance plan that would compete with private insurers offering coverage through the Affordable Care Act’s exchanges. The hope is that this competition can help keep premiums for all the insurance plans low, particularly if the government-run plan has the ability to dictate low reimbursement rates to doctors, hospitals, drugmakers, and other suppliers of medical care.
President Barack Obama and Democratic leaders included versions of the public option in their proposals when they first began working on health care reform in 2009. But they ended up jettisoning the idea in response to protests from more conservative Democrats, who were less enthusiastic about government programs and industry groups, like hospitals and insurance companies, that feared what a public option would do to their income streams.
The idea of a Medicare buy-in has been around for even longer, although it, too, appeared in 2009 when Democrats were drawing up health care legislation. The goal, again, would be to give consumers ― in this case, those older than 55 and at greater risk of becoming sick ― one more insurance option if they can’t get coverage through an employer or an existing government program.
Clinton has expressed support for both ideas during the 2016 campaign, noting that she had called for them previously. (She made a public option part of her campaign proposal to reform health care in 2008.) But campaign aides said Saturday’s announcement is a reminder of how seriously she takes the idea ― and her determination to promote it as president.
That might reassure some of the progressive Sanders supporters skeptical of Clinton’s commitment to their values and goals ― and, in some cases, angry at her attacks on Sanders’ proposal to create a single, government-run insurance plan that would provide coverage to all Americans, supplanting private insurance altogether.
Of course, Clinton’s announcement comes with no policy details. She isn’t answering any of the many complicated questions that either proposal would raise ― like exactly how either the Obamacare public option or Medicare buy-in plan would pay the providers of medical services, or exactly who could enroll in either one.
Clinton’s call to increase funding for federally run health clinics is a bit more specific, in that she’s put a dollar figure on it. It would be $40 billion over 10 years. She hasn’t identified new revenue or spending cuts to cover the cost of the proposal, but she has said that she will remain true to her pledge to pay for the price of any proposals ― a pledge that she has largely kept in this campaign, independent budget analysts say.
And while the clinic proposal likely to get a lot less attention than anything Clinton says about the public option of Medicare, the idea, if implemented, could help a great many people get medical care.
The clinics are the backbone of the nation’s health care safety net, providing primary care to millions of Americans who either have no health insurance or whose insurance doesn’t meet their needs ― a group that, even after the implementation of the Affordable Care Act, is large and underserved.
About one in 14 Americans currently gets health care through a federally funded clinic, according to the Department of Health and Human Services. That’s thanks to annual funding of about $5 billion, a big chunk of which comes from a provision in the Affordable Care Act that Sanders championed.
“This would be a substantial infusion of funding,” Larry Levitt, senior vice president of the Henry J. Kaiser Family Foundation, told HuffPost. “More funding for community health centers creates an infrastructure to care for increasing numbers of insured people and also provides resources to reach the remaining uninsured to encourage them to get covered.”
Federal clinics happen to be one of the few government-run healthcare programs with a history of strong bipartisan support. George W. Bush was a big fan during his presidency, for example. So while both a public option and Medicare buy-in would likely run into the same political opposition that stopped them in 2009,more money for clinics would have a chance of becoming law even with Republicans controlling a house of Congress.
This article has been updated to include more specific details on Clinton’s proposal and reactions to it.
CLARIFICATION: Language has been updated to indicate that Clinton expressed support for the public option on her campaign site before the Saturday announcement.