U.S. Representative Angie Craig (D-Minnesota) introduced a bill last week that aims to create a government-run public health insurance option on the Affordable Care Act Marketplaces.
The bill is called the Medicare-X Choice Act and is co-sponsored by Reps. Eleanor Holmes Norton (D-DC) and Mike Quigley (D-Illinois). It would create a “Medicare Exchange health plan” that would become available in 2028 for the individual market and the small group market. It would not be available for those eligible for Medicare.
The health plan would cover primary care services without any cost-sharing requirements. In addition, providers and hospitals would be reimbursed at traditional Medicare payment rates, though HHS can increase payments by up to 50% in rural areas. Medicare and Medicaid providers would be required to participate in the public plan option.
The bill would also make the ACA enhanced premium tax credits, which expired at the end of 2025, permanent. These enhanced tax credits were established in 2021 during the Covid-19 pandemic and lowered premiums for coverage on the ACA marketplaces.
Following the expiration of the enhanced premium tax credits, average monthly Marketplace premium payments increased 58%, from $113 to $178, according to KFF.
“Even before Republicans made historic cuts to Medicaid and stripped the American people of the ACA tax credits they relied on to afford health coverage, it was too expensive to be sick in this country,” Craig said in a statement. “Now, thousands of Minnesotans have lost MNSure coverage and countless others are paying through the roof just to access the basic health care they need. But it doesn’t have to be this way. A public option will offer folks across this country lower premiums for quality care, and that’s why I’m proud to be introducing this common-sense legislation in the house – to actually lower health care costs and increase competition in the marketplace.”
In December, Senators Michael Bennett (D-Colorado) and Tim Kaine (D-Virginia) introduced a companion bill in the Senate.
“In the wake of a looming health care crisis, Medicare-X will give everyone an affordable option regardless of where they live, reduce health care costs, and improve the quality of available insurance,” Bennet said after introducing the Senate bill. “We have a responsibility to create the best health care system possible, achieve universal coverage in our country, and save millions of Americans from being thrown off their health insurance. We can do that through Medicare-X.”
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