Sly Talk: MJ’s “Steppingstone” to Medicare-for-All

Election Day is 9 days away and Texas voters still don’t know who MJ Hegar is — let alone her policy plans. The latter is a result of her deliberate evasiveness toward deep dives into policy. 

“She’s been very vague because she’s trying to win over crossover voters while at the same time not alienating progressives,” Rice University political scientist Mark Jones told the Dallas Morning News. Call it vague — We say dishonest. And Texans aren’t going to stand for it. 

Today we look at: MJ’s “Steppingstone” to Medicare-for-All

Like Joe Biden, MJ Hegar is sly about her plans for healthcare. Both rebuff being labeled as “Medicare-for-All” supporters, but then boast about their public option plan. But MJ tipped her hand on her long-term aspirations in an interview with the Texas Tribune (49:20): “I do like Medicare and I do think a ‘Medicare for All’ model could work… “What I would like, at least, as a steppingstone, is a Medicare option for people.” 

The Biden-Hegar “Steppingstone” plan would eventually phase out private, employer-provided insurance for 13.5 million Texans. MJ told the Texas Signal: “Yes. I think they should be able to keep private insurance. I don’t think most people will choose to do that as this model grows and people realize how much better Medicare is.” (6/10/19) And at a May 2020 town hall said: “And I think, at first, people need to be able to choose to stay on their private insurance if they choose to do that. But I don’t know why they would. But there is a perception problem that we have to overcome in this country, okay?” (5/20/20)

The Biden-Hegar steppingstone to M4A will result in:

  • Higher taxes
  • An overburdened Medicare system (threatening solvency for the 3 million Texas seniors currently on Medicare)
  • Many rural hospitals to clos

It shouldn’t surprise anyone that Hegar would use her so-called public option to push Texans toward M4A. In 2018, Hegar told the Texas Tribune “single-payer is the future of our health care system.” (8:26) Furthermore, she said a “Medicare for All” model “could be great.” (49:20)  

In December 2019, Hegar told Evan Smith of the Texas Tribune she would pay for expanding Medicare by raising taxes: “So, there’s a lot of ways that we’re going to pay for it. First of all, I think that, you know, we keep increasing the deficit every time we grant tax breaks to the top, not even 1%, 0.1%.” …  SMITH: “Are you going to raise taxes on people above a certain income level?” HEGAR: “I think taxes will go up on people above a certain income level.” 

SMITH: “Ms. Hegar, you artfully switched to the passive voice and I’m not going to allow it. ‘Taxes will go up’ is not the same as ‘I will raise taxes.’ Will you – you – vote to raise taxes on people above a certain income?” HEGAR: “I will insist people pay their fair share.” (12/11/19, 32:56)

If that wasn’t harmful enough, the Biden-Hegar “Steppingstone” M4A plan would have a devastating impact on Texas’ rural healthcare. More than a quarter of hospitals in Texas are in rural communities. A single-payer government health care program paying Medicare rates would force rural hospitals to close or drastically scale back their services and staff. Those that remain open would have to forgo future purchases of new equipment and technologies, and the latest training for medical staff.

9 days to Election Day. Texans must be told of MJ’s sly plans.

The Biden-Hegar “Steppingstone” to Medicare-for-All

Joe Biden’s Public Option Plan Carries A Gross Ten-Year Cost Of $2.25 Trillion And An Estimated $800 Billion Added To The Deficit

According To An Analysis By The Committee For A Responsible Federal Budget, Biden’s Health Plan—Which Relies On A Public Option—Has A Gross Cost Of $2.25 Trillion And Would Add $800 Billion To Deficits Over Ten Years After Offsets. “Vice President Joe Biden’s health plan has a gross cost of $2.25 trillion and, incorporating offsets, would add $800 billion to deficits over ten years under our central estimate. It would save $300 billion in our low-cost estimate and add $1.3 trillion to deficits in our high-cost estimate.” (“Primary Care: Estimating Democratic Candidates’ Health Plans,” Committee For A Responsible Federal Budget, 2/26/20)

Biden’s Plan Includes Increased Obamacare Subsidies And A Public Option For Those In The Individual Market Or With Employer Coverage. “Vice President Joe Biden proposes to expand the Affordable Care Act by increasing marketplace subsidies, adopting auto-enrollment, and offering a new public option available to those in the individual market or with employer coverage. Biden would also offer a new long-term care tax credit and increase funding for rural health and mental health services.” (“Primary Care: Estimating Democratic Candidates’ Health Plans,” Committee For A Responsible Federal Budget, 2/26/20)

“To Finance The Costs Of This Plan, Biden Would Enact Reforms To Reduce Prescription Drug Prices, Lower Other Health Care Costs, And Raise Taxes On Capital Gains And Ordinary Income For High Earners And Heirs.” (“Primary Care: Estimating Democratic Candidates’ Health Plans,” Committee For A Responsible Federal Budget, 2/26/20)

M4A’s Impact on Texas Healthcare

A 2019 Analysis By Guidehouse Found That The Public Option Could Place As Many As 55% Of Rural Hospitals, Or 1,037 Hospitals Across 46 States, At High Risk Of Closure. A new analysis of U.S. rural hospitals has found that offering a government insurance program reimbursing at Medicare rates as a public option on the health insurance exchanges created by the Affordable Care Act (ACA) could place as many as 55% of rural hospitals, or 1,037 hospitals across 46 states, at high risk of closure. The rural hospitals at high risk represent more than 63,000 staffed beds and 420,000 employees, according to the analysis by Guidehouse Inc. Even those rural hospitals not at high risk of closure and the communities they serve face an increased threat. The availability of a public option could negatively impact access to and quality of care through rural hospitals’ potential elimination of services and reduction of clinical and administrative staff, as well as damage the economic foundation of the communities these hospitals serve.” (Jeff Goldsmith And Jeff Leibach, “The Potential Impact Of A Medicare Public Option On U.S. Rural Hospitals And Communities,” Guidehouse, 8/7/19)

A 2019 Study By The American Hospital Association And Federation Of American Hospitals Found That A Public Plan Reimbursing At Medicare Rates Could “Compound Financial Stresses” And Potentially Impact Access To Care And Provider Quality. “For hospitals, the introduction of a public plan that reimburses providers using Medicare rates would compound financial stresses already faced by the sector, potentially impacting access to care and provider quality. CBO projects that between 40 and 50 percent of hospitals could have negative margins by 2025 under current law.7 Given that Medicare pays hospitals below their costs (e.g., the Medicare Payment Advisory Commission estimates that Medicare inpatient margins will be -11 percent in 2018), Medicare-X Choice would be expected to increase the number of hospitals with negative margins. While hospitals may attempt to shift some costs to commercial insurers, the ability to do this under a public plan may be limited because of the study’s projected significant take-up by those in the non-group market. Policymakers should have a clear understanding of potential effects on patient access, provider payment, the commercial insurance market, and ESI (desired as well as unintended) when considering proposals to expand Medicare coverage.” (Lane Koenig et al, “The Impact Of Medicare-X Choice On Coverage, Healthcare Use, And Hospitals,” American Hospital Association and Federation Of American Hospitals, 3/12/19)