Exclusive poll: What voters want from “Medicare for All”

https://www.axios.com/medicare-for-all-poll-midterm-elections-e7b93daf-b261-42f7-85ca-8d1bcb2eb1f0.html

Voters like some form of “Medicare for All” but are divided over what it should look like, according to our latest Axios/SurveyMonkey poll — which is about the same situation Democratic candidates are in.

The big picture: Many of Democrats’ leading 2020 prospects, and a host of candidates in the midterms, have embraced “Medicare for All,” but there’s a big variation in the policies they propose under that banner.

Between the lines: We asked our poll respondents two related questions — what they think candidates mean by “Medicare for All,” and what they want that policy to mean, if they support it at all.

By the numbers: Overall, 52% of those surveyed said they think “Medicare for All” refers to a single, government-run health care program covering everyone. That’s what Sen. Bernie Sanders, who popularized the term “Medicare for All,” has proposed.

  • Republicans were more confident in that assessment than Democrats: 61% of Republicans said Medicare for All is single-payer, compared with 51% of Democrats. A plurality of independents — 42% — said they don’t think candidates are talking either single-payer or an optional program that would compete with private insurance.

Voters were more divided over what they want “Medicare for All” to be, given the same choices.

  • 34% said they would favor a single-payer system; 33% said they would prefer an optional public plan alongside private insurance; 30% wanted neither.
  • Democrats were far more open to a single-payer system than Republicans and independents.
  • Of the five voter subgroups Axios is following in the midterm elections, African-American women and young adults were most interested in some form of “Medicare for All,” while rural voters were least interested.

Add it up, and most people — 67% — seem to be on board with either single-payer or a public option, suggesting that “Medicare for All” is popular, but that’s partly because of its multiple meanings.

Yes, but: The 2020 Democratic primary will likely bring the issue into much sharper focus.

  • In the midterms, every Democrat can pick the definition that works best for their race. But with so many candidates running for the same office in 2020, putting a finer point on “Medicare for All” will be a big part of the larger Democratic debate.

 

 

 

Rural health care is expensive, and Washington isn’t helping

https://www.axios.com/rural-areas-aca-unaffordable-d45599c2-3823-4041-ad8c-696cf7c15d8f.html

Image result for Rural health care is expensive, and Washington isn't helping

 

Some of the Affordable Care Act’s biggest problems — rising premiums and lackluster competition among insurers — are most severe in rural areas. And those areas tend to be conservative, but there’s little serious effort among Republicans to address these problems.

Why it matters: Rising premiums put health care further out of reach for middle-class people in these areas. At some point, they’re going to want to hear workable solutions from their elected representatives.

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The problem: By definition, rural areas are sparsely populated. So there’s not much competition among hospitals and other providers, which means insurers don’t have much leverage to negotiate lower prices. And with fewer customers overall, one very expensive patient can have a disproportionate impact on a plan’s bottom line.

  • “Conservative approaches to dealing with health costs tend to revolve around a competitive market, but the challenge with rural areas is you don’t have the ingredients for a competitive market,” said Larry Levitt of the Kaiser Family Foundation.

What they’re saying: Broadly, Republicans have focused on proposals that would make it easier for healthy people to extricate themselves from the ACA’s insurance markets. Those consumers would likely pay less, but costs and competition would only get worse for the people who need the coverage guarantees the ACA provides.

“This boils down to money for services. One way or another you have to come up with the money, find a way to get the price of the services down, or find a way to not use all of the services.”
— Joe Antos of the American Enterprise Institute

The other side: There was some bipartisan support earlier this year for a new reinsurance program, which would offset the costs of insurers’ most expensive customers. Experts said it would have helped, including in rural areas. But it fell apart.

  • Democrats have proposed a slew of ideas they say could help ease the burden in sparsely populated regions, mostly at taxpayers’ expense — including a public option, an expansion of the ACA’s premium subsidies, or new caps on payments. But none of those ideas have any real chance of actually happening, at least any time soon.

The bottom line: Reinsurance is by far the most bipartisan solution to the rural problem. Even that couldn’t get through this Congress, and lawmakers aren’t expected to return to health care policy before the midterms. This problem will likely get worse before it gets better.

Could Minnesota Health Reforms Foreshadow Repeal And Replace?

http://www.healthleadersmedia.com/health-plans/could-minnesota-health-reforms-foreshadow-repeal-and-replace?spMailingID=10382992&spUserID=MTY3ODg4NTg1MzQ4S0&spJobID=1100574162&spReportId=MTEwMDU3NDE2MgS2#

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In the midst of the uncertainty about the Affordable Care Act, Minnesota has taken three unusual actions.

What’s going to happen to the federal health law? The quick answer is no one knows. But in the midst of the uncertainty about the Affordable Care Act, states still must govern their insurance markets. Most have been muddling through with the 2017 status quo, but Minnesota is a special case, taking three unusual actions that are worth a closer look.

Last month, Minnesota:

  • Passed a one-time bailout for some consumers in the individual insurance market dealing with skyrocketing premiums.
  • Rejected an attempt to let insurers offer cheaper, bare-bones coverage.
  • Laid the groundwork for a sort of homegrown “public option” insurance plan.

Here’s more on each item.