The uncertainty President Trump and the GOP's AHCA plan are creating in Washington is pushing state lawmakers to propose single payer legislation in their states. We have seen legislators act based upon unresolved sore points facing their constituencies. A shift to this system would be a complete redirection and cause a whole set of new issues and new unhappy Americans.
In short, people who serve the group market cannot ignore these individual market moves, because a push to single payer will affect everyone. Employers may stop offering health plans altogether.
Look at two states leading the charge. California has already passed a single-payer healthcare bill that would replace health insurance companies with state-funded health coverage, for example. This law has a $400 billion price tag, which is an astronomical number when one considers that the entire state budget is $125 billion. This proposal would require huge tax increases and possible cuts to school, environmental and public safety programs. Furthermore, analysts project total healthcare costs would increase by an estimated $50 billion to $100 billion a year, but most of the cost would be offset by existing state, federal, and private spending on health coverage.
In New York, single-payer has passed the Democratic-controlled Assembly for the third year in a row and is within one vote of getting through the narrowly-controlled Republican State Senate and to the Governor’s office for signature. Assembly Health Chairman Richard Gottfried, representing the 75thAssembly District in Manhattan, has been championing the issue based upon a poorly written, poorly researched 2015 analysis from a University of Mass. Amherst economist.
Also see: "Has the single-payer era arrived?"
Under the law, all private insurance would be banned and Medicare and Medicaid would be absorbed. There would be no copays or deductibles, and New Yorkers would be free to see any doctor or hospital and get any medication that was prescribed. It is easy to see why this would be appealing, but I’m not sure that any fiscally responsible person with a vote would possibly find this wonderland at all feasible.
Based upon these assumptions, the study indicated that New York taxes would double. If the law managed to pass, the anti-tax protestors would have a field day. While it is unlikely to pass the New York Senate, the signs are still not good that this is a well-thought-out solution. Since New York State has no automatic financial scoring like the Federal Congressional Budget Office, opponents will need to fund a more unbiased study.
Voters are passionate about the broken healthcare system and unless influencers like Assemblyman Gottfried are convinced that the so-called “experts” are moving forward with real solutions, propositions like these will inch closer to reality. I remain hopeful that despite Trump’s Russia complications, the federal government can pass incremental legislation to placate those fearful of the uncertainty ahead.
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