Seema Verma, the administrator of the Centers for Medicare & Medicaid Services, has come out strongly this week against the idea of a “public option” — a government-run insurance plan that would provide an alternative to private coverage. The idea has been promoted by a number of Democrats, including former Vice president Joe Biden, as an alternative to a more sweeping transition to a single-payer Medicare for All system that could involve the elimination of private insurance.
Advocates for a public option say it would lower prices by competing with private insurers while still allowing Americans who like their private plans to keep them. But Verma argues that a public option would force private insurers to flee the market, ultimately leaving a single-payer government-run system.
“The secret of the public option is that it’s only cheaper because it uses the force of government to strong-arm doctors and hospitals into accepting below-market payment rates. But the government cannot wave a wand and impose lower rates on some providers while holding everyone else harmless,” she said in a speech Monday. “Access will be compromised for patients, and reimbursement cuts in the public plan will shift more pressure to employer-sponsored plans to make up the difference, driving up costs for 180 million Americans with private insurance. Make no mistake – the public option is a Trojan horse with a single payer hiding inside. It would use the force of government price setting to crowd private insurers out of the marketplace altogether, and achieve the true policy goal of a government-run single payer healthcare system.”
Verma, who has also criticized Medicare for All, followed up with an op-ed in The Washington Post based on her speech.
“Millions of Americans rely on Medicare and Medicaid. We made a promise to our nation’s most vulnerable to ensure they have access to health coverage. There is something deeply unjust in dumping millions more onto these programs, which are already on an unsustainable fiscal path,” she wrote. “Instead of introducing even more government intrusion into the markets, we must strengthen and protect our existing safety-net programs and address the drivers of costs by fostering a competitive and dynamic private market in which plans and providers compete on the basis of cost and quality — not a system that makes promises that can’t be kept and leaves taxpayers to clean up the mess.”