WASHINGTON - Progressive Democrats, more confident that the legislative threat to the Affordable Care Act has passed, are adding a new bill to their stack of health-care legislation - one that would allow people to buy into a Medicaid "public option" in their states.
The State Public Option Act, sponsored by Sen. Brian Schatz, D-Hawaii, in the Senate and Rep. Ben Ray Luján, D-N.M., in the House, would expand Medicaid from a program available only to Americans at or slightly above the poverty level, to a universal program anyone could buy into. Already, 18 Democrats in the Senate have co-sponsored the bill, including Sen. Bernie Sanders, I-Vt., and most of the party's potential 2020 presidential candidates.
"Medicaid itself took awhile to catch on in every state; it wasn't until 1982 that every state participated," said Schatz in a joint interview with reporters this week. "Over time, as the politics settle down, states will avail themselves of this opportunity."
Schatz had worked on the bill for months, inspired - as he told Vox in August - by the surge of public support for the Affordable Care Act's Medicaid expansion that followed Republican attempts to repeal "Obamacare." Over the summer, before Republicans resurrected their repeal attempt, Nevada's Democratic-controlled legislature passed a bill that would have made Medicaid universal; it was vetoed by Gov. Brian Sandoval, R-Nev. But the Nevada experience resonated on the left.
Even in deep blue states like Vermont and California, attempts to remake the health-care system with single-payer plans have been stymied by cost and complication. The Schatz bill takes the Nevada idea nationwide.
"Our bill builds on a system that already works - a system that is already in place in every county in every state in the country; and a system that has built-in efficiencies," Lujan said at the joint interview and in a statement.
Like Sanders's universal Medicare bill, the Schatz legislation does not contain taxes to pay for its cost. Like Sanders, Schatz suggested analysts could get cracking. "That includes getting a CBO score; that includes getting a pay-for," he said.
In September, Republicans requested a CBO score on Sanders's legislation. It has not yet been released.