Buttigieg unveils health plan, calls it 'glide path' to Medicare for All
WASHINGTON — Democrat Pete Buttigieg is unveiling his long-awaited health care plan that aims to move millions of Americans into government-run health care without imposing it on all Americans all at once — a middle ground that Buttigieg hopes will draw a clear contrast with the "Medicare for All" approach.
The South Bend, Ind. mayor and presidential candidate described his plan as a "glide path to Medicare for All" in an interview with NBC News.
While Sens. Elizabeth Warren, D-Mass., and Bernie Sanders, I-Vt., propose eliminating private insurance in one fell swoop, Buttigieg wants the government to introduce a public plan that would be so competitive that Americans will ultimately choose voluntarily to abandon insurance companies.
"Freedom is one of the main themes of this campaign. And I do think commanding Americans to abandon the coverage they've got is inconsistent with our commitment to freedom," Buttigieg said.
He said unlike his rivals' "Medicare for All" proposal, his plan allows for as long a transition period as necessary to get the public option up and running well, a concern highlighted by the disastrous rollout of the HealthCare.Gov online insurance marketplace during the Obama administration.
Buttigieg said leaving the current system intact while any unforeseen kinks in the public option are ironed out would be "far less traumatic" than putting the entire country in government-run health care all at once.
Buttigieg's plan hews closely to the proposal backed by former Vice President Joe Biden, the Democratic primary's front-runner. But their plans differ over how Americans would get enrolled in the new public plan and what subsidies would be available to help them pay for it.
Under Buttigieg's proposal, Americans would again be effectively required to maintain some type of health insurance, a requirement put in place by President Barack Obama's Affordable Care Act but nullified by the Trump administration.
Americans whose incomes are so low that they're eligible for free coverage through Medicaid or the public option would be automatically enrolled, along with those eligible for "an affordable insurance option," although Buttigieg's plan doesn't explicitly define what constitutes affordable. Those Americans could opt out of the public option if they have private insurance, and even those with employer-provided insurance could choose to use the public option instead.
Those who aren't automatically enrolled and lack insurance would later be "retroactively enrolled" in the public plan. Buttigieg said they'd have to pay back premiums for the time they were uninsured if they get sick and need coverage.
But critics have long argued that allowing people to wait until they're sick to get insurance drives up health care costs because there are fewer healthier people — who cost less to insure — to pay into the system.
Buttigieg would also expand subsidies to help pay for premiums — currently limited to people whose incomes are less than four times the federal poverty level. Under his plan, Americans could buy into a "gold-level" public option at a premium capped at 8.5 percent of their income.
"This plan is not moderate by historical standards, but it certainly is moderate compared to Medicare for All," said Larry Levitt, executive vice president for health policy at the Kaiser Family Foundation, which studies health care policy. "It goes well beyond the Affordable Care Act in providing help paying for healthcare to a much larger number of people and taking significant steps to control costs."
As Buttigieg works to break into the top tier in the crowded Democratic race, his critiques of his competitors and their plans have become increasingly sharp and direct in recent weeks. An NBC News-Wall Street Journal poll this week found Buttigieg in fourth place at 7 percent, far behind Biden at 31 percent, Warren at 25 percent and Sanders at 14 percent.
In Facebook ads taking aim at Sanders and Warren over health care, Buttigieg has argued their vision would "dictate" a public option to Americans and "risk further polarizing them."
And although Warren and Sanders cite statistics showing Americans support Medicare for All, Buttigieg says in the NBC News interview that a closer look reveals that what the majority are thinking of when they hear "Medicare for All" is actually closer to his plan, not those of the two senators.
The Buttigieg plan also cracks down on exorbitant costs insurance companies charge for providers who are out-of-network by capping their reimbursement rates at double the rate that Medicare pays. It would also aim to end "surprise bills" that result when patients go to an in-network hospital but are unknowingly treated by an out-of-network provider working there.
—Benjy Sarlin contributed