- The Washington Times - Tuesday, January 8, 2019

House Budget Committee Chairman John Yarmuth asked congressional scorekeepers Tuesday to outline for Democrats the logistical and financial trade-offs they must consider as they craft bills to provide “Medicare for all.”

The Kentucky Democrat’s letter to Keith Hall, director of the Congressional Budget Office, is the latest sign that newly empowered liberals are taking the idea of a government-run, single-payer system seriously.

Mr. Yarmuth said he will hold hearings on the idea pushed by prominent voices like Sen. Bernard Sanders of Vermont and Rep. Alexandria Ocasio-Cortez, who say the U.S. should follow the lead of places such as Canada and Europe in providing universal coverage.

But first he wants a to-do list to guide their bill-writing, from who would be newly eligible to how doctors would be paid under a sweeping overhaul.

“Members of Congress developing proposals to establish a single-payer system will face many important decisions that could have major implications for federal spending, national health care spending and access to care,” Mr. Yarmuth wrote.

Single-payer health care has served as an aspirational goal for liberals for decades, and many Democratic 2020 presidential hopefuls have rallied around the idea.

Since taking the House majority, Democrats have taken tangible steps to begin forging a plan for public scrutiny.

House Rules Committee Chairman James McGovern and Mr. Yarmuth plan to hold hearings on the idea, although committees that typically deal with health care are focused on more limited plans to defend or bolster Obamacare.

Mr. Yarmuth’s letter is the next step in the more ambitious side of Democrats’ plans. He wants to know which agencies would administer a single-payer system, how people would enroll, what role private insurers would pay and how much the whole thing might cost taxpayers.

The request, he noted, does not ask CBO scorekeepers to evaluate the costs of any specific proposal — a key step in pushing major legislation — although “would, to the extent feasible, provide a qualitative assessment of how the choices with respect to major design issues would affect such spending.”

Republicans are salivating over the prospects of a debate over a “government takeover” of health care, betting the eye-popping price tag of trillions in taxpayers spending will sink Democrats at the ballot box.

Progressives pushing single-payer insist the idea will be a saver in the long run, as spending supplants runaway costs in the private insurance and prescription-drug markets and people access care before their health problems worsen.

• Tom Howell Jr. can be reached at thowell@washingtontimes.com.

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