- Associated Press - Thursday, December 19, 2019

WASHINGTON (AP) — Putting his stamp on the top issue for Democratic voters, Michael Bloomberg on Thursday unveiled a health care plan that would expand coverage and cut people’s costs by building on the current system, not replacing it.

The former New York mayor and Democratic presidential candidate embraced a new government-run “public option” to compete with private insurance and called for Medicare to negotiate drug prices, using an approach similar to House Speaker Nancy Pelosi’s recent legislation.

“It’s in the Biden-Buttigieg world rather than Sanders-Warren,” said John Holahan, a health policy expert with the nonpartisan Urban Institute think tank. Holahan reviewed an outline of the plan provided by the Bloomberg campaign.

On health care, leading 2020 Democrats are divided between the step-by-step strategy favored by moderates like former Vice President Joe Biden and South Bend, Indiana, Mayor Pete Buttigieg and the “Medicare for All” plan envisioned by Vermont Sen. Bernie Sanders and seconded by progressives wanting a single, government-run system for all Americans. Massachusetts Sen. Elizabeth Warren has that as her ultimate goal.

Bloomberg was announcing his plan during a speech in Memphis. The state of Tennessee is one of 14 that has not expanded Medicaid for low-income people under the Obama-era Affordable Care Act, or ACA. Tennessee copes with a high burden of chronic illness and ranked 44th this year in an annual state-by-state report card from the nonprofit United Health Foundation.



“We’ll make sure that people who like their private insurance can keep private insurance, while also providing coverage to the uninsured,” Bloomberg said in speech excerpts provided by his campaign. “We don’t need Medicare for All proposals that are more likely to reelect Donald Trump than expand coverage.”

The Memphis speech came a day after a federal appeals court in New Orleans left “Obamacare’s” future in doubt, ruling that the law’s now toothless requirement for Americans to get health insurance is unconstitutional. The decision keeps the rest of the law in place for now, subject to additional court review.

Bloomberg would not reinstate the unpopular “individual mandate,” as the Obama-era coverage requirement is known. Instead, he’s calling for an extensive outreach campaign to voluntarily sign up uninsured people, relying on a strategy he piloted as New York mayor.

The campaign said the plan would cover most of the nation’s estimated 27.5 million uninsured people.

Key elements of the Bloomberg plan include:

- Extending subsidized coverage under the ACA to cover more people and creating a permanent federal program to help insurers pay for the costliest patients, an approach that has been shown to lower premiums.

- A new “public option” health insurance plan run by the government and modeled on Medicare. It would be focused on low-income people and residents of states that have not expanded Medicaid. Individuals would be eligible for help paying their premiums through the ACA’s subsidies.

- Empowering Medicare to negotiate prices for the costliest brand-name drugs, capping prices at 120% of the average in other economically advance countries. Privately insured patients would be able to get Medicare’s prices. Seniors’ out-of-pocket costs for medicines would be capped at $2,000 per year.

- Creating a new Medicare benefit for dental, hearing and vision care with a premium of $25 a month for beneficiaries.

- Ending so-called “surprise medical bills” for people covered by private insurance when they’re treated by a provider outside their plan’s network. The plan would cap out-of-network hospital charges at 200% of what Medicare pays.

The Bloomberg campaign said the plan would cost about $1.5 trillion over 10 years, with some of that covered through expected savings on prescription drugs. Officials said Bloomberg intends for the plan to be fully paid for, so it would not add to the government’s mounting debt.

Campaign officials said Bloomberg is also working on a plan to improve basic public health throughout the country, reflecting another priority of his as New York’s mayor.

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