Republicans have a counter, though no one yet knows what it is. President Trump has promised…to show what it is after the 2020 elections. He has endorsed some proposals already, which may be included in his more comprehensive plan. One (Graham-Cassidy) shows the elimination of the ACA Medicaid expansion and insurance subsidies, with the money being reallocated to the states, who would also be able to override some ACA benefit standards. The 2020 White House budget points to this by creating block grants to the states for a similar purpose. Conservatives also have a plan, which follows a similar path. In short, everyone is against having the Federal government run it – they are all passing to the states.
Of course, Trump really does need a plan, given that his 2020 budget calls for a cut of more than $845 billion in Medicare, purportedly to “cut waste, fraud and abuse.” The OMB director said “he’s not cutting Medicare in this budget” so…so how can we have Medicare for all when Medicare itself is always under attack?
The general grouping of proposals are:
- Passing block grants and funding to the states
- Adding public plan features to private insurance
- Giving people a choice of public plans alongside private plans (e.g. Medicare for those age 50 to 64 while still being able to buy private insurance instead)