Progressives have been trying to get complete government control of health care for over 100 years. I wrote about this in my first book, The ObamaCare Train Wreck, in 2014. The roots of the progressive movement can be traced to President Theodore Roosevelt. Roosevelt supported the concept of national health insurance, but never actively pursued legislation to implement it. In 1906, the American Association of Labor Legislation (AALL) began work to achieve this concept.
The Socialist Party of America proposed socialized medicine through national health insurance as early as 1928 in their party platform. Historians differ on when the first bill for national health insurance was actually introduced in Congress. The Wagner National Health Act of 1939, introduced by Senator Robert Wagner (D-NY), may have been the first. It never received the support of President Franklin D. Roosevelt. The bill evolved into the Wagner-Murray-Dingell Bill in 1943 and called for compulsory national health insurance and a payroll tax. But it never got out of committee because it lacked Roosevelt’s support. He feared it would lead to socialized medicine and the AMA did not support it. Nevertheless, it was reintroduced every session of Congress for the next fourteen years.
Then came ObamaCare. In 2010, President Barack Obama signed the Affordable Care Act into law, a bill that will forever be associated with his name. Then Vice-President, and now President Joe Biden, was caught on an active microphone telling Obama, “This is a big f***ing deal!” For once, Biden may have gotten it right.
But ObamaCare only moved the ball forward a little. It still retained the private health insurance that most Americans receive through their employer and would hate to lose. ObamaCare mainly increased the rolls of Americans with health insurance by increasing the enrollment of Medicaid. About 15 – 20 million Americans now had health insurance who were formerly uninsured, most through Medicaid. This happened because ObamaCare changed the eligibility rules of Medicaid to include those earning up to 138% of the Federal Poverty Level (FPL) and provided subsidies to pay for premiums on the ObamaCare exchanges for those earning above 138% FPL and below 400% FPL.
Then came Covid. The pandemic gave the government the excuse to suspend the rules for removing people who become ineligible for Medicaid. The Families First Coronavirus Relief Act of March, 2020, barred states from removing people who become ineligible from their Medicaid rolls for the duration of the public-health emergency in return for a bump in federal funding.
While this bill was passed during the Republican administration of President Trump, it is the Democratic administration of President Biden that is making full use of the crisis. In a classic example of “never let a crisis go to waste”, the Biden Administration has repeatedly extended the public health emergency to increase the rolls of Medicaid. The next deadline for these rules to end is October 13, but who really believes the Biden administration won’t renew the emergency again just before the mid-term elections.
This pandemic crisis has enabled them to stealthily increase the number of Americans on government-paid, and government-controlled, healthcare. The Wall Street Journal editorial board says if not for Biden’s recurring emergency declaration, about 20 million Medicaid enrollees would no longer be eligible, most because their incomes exceed the threshold for qualifying – even the elevated ObamaCare income levels. Many of these would get private health insurance from their employers, but why pay insurance premiums when the government is giving you Medicaid “free?”
Taxpayers, naturally, are the big losers in this deal. Annual Medicaid spending has increased by $198 billion during the pandemic. That’s about as much as Medicaid spending grew from 2012 to 2019 during the first seven years of the ObamaCare expansion.
In addition to expanding the rolls of Medicaid, the Biden Administration has expanded the rolls of ObamaCare. The American Rescue Act of March, 2021 expanded ObamaCare exchange subsidies to millions of Americans. As a result, millions pay no premiums, and households making more than 400% of FPL receive generous subsidies. The Congressional Budget Office (CBO) initially estimated the two-year subsidy expansion would cost $22 billion, but the actual cost was $50 billion.
To make matters worse, the recently passed Schumer-Manchin spending bill, misnamed the Inflation Reduction Act of 2022, has extended these expanded subsidies for another three years. The CBO has bizarrely forecast the cost will be a mere $30 billion. In a classic display of “funny math,” the CBO expects three years of subsidies will cost 34% less than two years!
Furthermore, the CBO doesn’t account for the Biden Administration’s proposed regulation to fix ObamaCare’s so-called “family glitch,” which limited exchange eligibility for many individuals offered family coverage through their employers. If enacted, the change would make an estimated five million more Americans eligible for more generous subsidies on the ObamaCare exchanges.
What is the impact of all these changes?
The Health and Human Services Department recently reported that the “National Uninsured Rate Reaches All-Time Low in Early 2022.” HHS estimates there are 5.2 million fewer uninsured Americans than in 2020. Yet Medicaid rolls during the pandemic have actually swelled by 24 million – a 34% increase – while two million more adults have enrolled in ObamaCare exchange plans. In other words, most of the change is people moving from private health insurance to government-controlled health insurance.
WSJ summarizes the impact: “The Administration appears to want to drive more people into Medicaid and tightly regulated ObamaCare plans, and thus make more Americans dependent on government for healthcare. Government also subsidizes employer coverage through the healthcare tax deduction, but this is significantly less expensive for taxpayers.”
This is simply the Progressive movement pushing for complete government takeover of healthcare, one step at a time.