Inching toward universal healthcare: New York City to guarantee healthcare to everyone, Washington State plans a public option

A demented old racist has taken our federal government and TV news bureaus hostage, so it’s easy to overlook the progressive policy announcements made over the last few days. But with new Democratic administrations taking office and others looking to make a splash, it’s been a good few days, especially for healthcare policy.

In New York on Tuesday, Mayor Bill de Blasio announced that the city would be moving toward guaranteed healthcare for undocumented immigrants and low-income residents. It’s not any kind of Medicaid expansion — states run that program — or new health plan, but instead, a guarantee of proactive care that won’t cost patients anything if they can’t afford to pay.

From the NY Times:

The city already has a kind of public option for health insurance for low-income New Yorkers, through an insurance plan run by city hospitals known as MetroPlus.

The new proposal would improve that coverage, which already insures some 516,000 people, and aim to reach more of those who are eligible, such as the young and uninsured, and others who qualify but have not applied.

It would also provide additional direct city spending, at least $100 million per year when fully implemented, officials said, for the city’s hospital system to support care for those without insurance. The city estimates the uninsured population to be about 600,000 people, including as many as 300,000 undocumented residents. A major component of that effort would be improving customer service, including the phone line, to help those with questions about their care.

The program will have a membership card that will allow patients to get care from a wide array of doctors. Right now, over half a million people use the city’s emergency rooms for their medical care, which is a very unhealthy and fiscally disastrous status quo. According to NBC New York, this new program will allow people to seek “primary and specialty care, from pediatrics to OBGYN, geriatric, mental health and other services.”

It will launch next year in the Bronx and in 2021 in the other four boroughs.

Meanwhile, in Washington State, Gov. Jay Inslee — a rumored potential presidential candidate — has proposed a “public option” on the state’s health insurance exchange. Right now, 14 counties in the state only have one plan offered on the exchange, which would make this a crucial addition.

Via the Seattle Times:

The proposal would have the state Health Care Authority contract with at least one health-insurance carrier to offer qualified health coverage on the Washington Health Benefit Exchange, according to a summary of the proposal.

The plan would be designed with transparent and consistent deductibles, copays and coinsurance, according to the summary, and would “compete on premium price, provider networks, customer service, and quality.”

How it will work remains to be seen; hopefully, the carrier contracted by the state will just be doing the administrative work, not making decisions on coverage and payment. The public option will have subsidies, it should be noted, which is encouraging.

On Monday in California, newly sworn-in Gov. Gavin Newsom took the first stepstoward a state single-payer healthcare system, while proposing more immediate coverage for the 138,000 young people living in the state.

With four red states voting for Medicaid expansion this past fall, it’s clear that public opinion is moving toward true universal care. Even the Trump administrations, evil as it is, recognizes that. In a story yesterday at the Federalist, Trump officials are depicted as trying to find a way to expand Obamacare (really!) so that takes pressure off Republicans without also pissing them off (they want political cover, while helping as few people as possible.

Indiana already has a weaker Medicaid expansion, carved out during negotiations with the Obama administration, and it’s likely that other states, like Mississippi, would opt for lower cutoffs for assistance and potentially work requirements — a Republican candidate for governor there this year just came out in support of such a set-up. In better news, Idaho, one of the red states where voters just approved an expansion, looks like it won’t have work requirements on its Medicaid.

We’re not at Medicare for All yet, which means we’re 70 years behind the rest of the world, but this is how progress is made in America: local and state governments taking the lead, proving that things can be done, and dragging Washington into the future.

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