Alabamans face enough challenges when it comes to accessing high-quality, comprehensive health care — particularly in our many rural communities where families are more likely to be uninsured or underinsured. While the promise of Medicare for All or a public option may sound alluring, these kinds of government-controlled health care insurance systems would likely only make it that much harder for patients in need to access and afford the vital care they need.
According to a recent study released by FTI Consulting, introducing a public option to “compete” on the ACA’s health care exchanges would eventually crowd out the individual insurance marketplace and force millions of Americans off their private insurance. In fact, the study found that after the introduction of the public option “20 percent of state marketplaces would no longer offer a single private insurance option by 2028.” By 2050, that figure would grow to nearly 70%, “representing nearly a quarter of marketplace enrollees.”
The study also found that within the first year following the introduction of a public option, “over 130,000 Americans enrolled in ACA coverage would be forced off of their existing health care plan.” Over a decade, that figure would swell to up to 2 million, and by the end of that decade, over 7 million Americans would no longer have access to private health insurance. Instead of giving patients more options, the study found that the public option would reduce choices and force Americans into a one-size-fits-all government health insurance system.
As someone who has worked in the health care insurance industry for 16 years, I can attest to the fact that one-size-fits-all rarely works when it comes to health care coverage. That is part of the reason that policymakers should be working to strengthen and protect the current blend of private coverage, employer-sponsored plans, and government programs like Medicare and Medicaid that currently provide so much flexibility for patients.
Instead of supporting this level of choice and flexibility, a public option or Medicare for All system would only lead to higher costs for hardworking American families, less access for and a lower quality of care, and less control over the doctors and treatments that would be covered for patients in need. Patients would end up spending more for poorer health care outcomes as private and employer-sponsored premiums rise because the public option or Medicare for All system would slash payments to doctors, forcing providers to shift those costs to those in the private market. This is no way to solve America’s health care woes.
Instead, we need to consider innovative ways to bring care directly to the underserved populations and rural areas while lowering health care costs in Alabama and across the country. Services such as telemedicine and direct primary care (DPC) allow more Alabamians to get access to the primary care services they need even if they lack existing insurance coverage. Since much of the state’s rural areas do not have access to adequate internet, Alabama must improve broadband access in these areas to even offer services like telemedicine. By offering mobile health services, patients are able to access healthcare services at a lower cost than face-to-face consultations.
I have said it before and will say it again—our health care system may not be a perfect one, but with the passage the Affordable Care Act (ACA), it is one in which roughly 290 million Americans have access to health care coverage, including essential benefits. The path forward should not be to scrap all the progress we have made, but to continue to build upon, improve and strengthen the ACA through practical reforms that will help lower costs and expand coverage to more Americans who need it.
Ultimately, it is through these small, but practical policy improvements — like continuing to expand Medicaid in the states that have yet to do so, increasing federal subsidies to help working-class Americans not covered by their employers afford coverage, reprioritizing education around enrollment periods and offering innovative ways to bring telemedicine to rural and underserved areas — that we can strengthen our health care system. That’s what legislators should be focusing on instead of pushing for absolute governmental control over our health care insurance system.
Curtis Cannon is a board member and speaker for Employee Benefit Advisors and Managing Partner of Axis Recovery, a healthcare consulting firm in Alabama.
