What ‘United States of Care’ Truly Cares About
There’s a new kid on the health policy block. A deep-pocketed, nominally bipartisan advocacy group called United States of Care — which counts former governors, senators, and top health policy officials among its members — launched earlier this month to great media acclaim.
Since its debut, the group hasn’t said much. Its stated policy goals are so vague that it’s hard to make out what, exactly, the group aims to accomplish.
Do a little digging, however, and it becomes clear that that United States of Care is laying the foundation for the same “Medicare for All” system that Sen. Bernie Sanders, I-Vt., and his allies are eager to implement.
The group’s rhetoric seems designed to offend no one. United States of Care promises to put patients’ “health care over politics,” to “gather and support the best ideas,” and to “ensure that every single American has access to quality, affordable health care.”
It hopes to accomplish these goals by testing various policy solutions at the state level and eventually applying those lessons nationally. It’s hard to disagree with federalism and evidence-based policymaking.
But such bland assurances obscure the big-government policy goals animating the organization.
United States of Care is the brainchild of Andy Slavitt, who ran the Centers for Medicare and Medicaid Services during the Obama administration. Slavitt was instrumental in Obamacare’s implementation.
He also emerged as one of the law’s most vocal and partisan defenders during last year’s repeal-and-replace effort. That he now claims to be taking politics out of the healthcare debate seems more than a little disingenuous.
Slavitt has stated that the group will look at “anything that can get people access to the coverage they need . . . That absolutely includes single-payer.”
In the past, Slavitt has criticized Sen. Sanders’ single-payer push — but only because he thinks it is bad politics. In his opinion, “we are realistically not within four years of having a single-payer bill or a universal coverage bill passed.” So he advises Democrats to adopt a more incremental approach, to “invest the time in listening … (to) how people think about the trade-offs and how they think about the options and what features they’d like.”
Some of the group’s other members have been more explicit about their single-payer aspirations. Jon Favreau, President Obama’s former speechwriter, recently explained his decision to back United States of Care, tweeting “I’m a #MedicareForAll advocate. I also want to make sure there’s a path to get there, which involves building a movement and persuading people who don’t currently agree.”
He added, “I wouldn’t have joined the group if they were trying to derail single-payer.”
By starting at the state level and then expanding nationwide, Slavitt and his colleagues are applying the Obamacare playbook to “Medicare-for-All.”
Obamacare, after all, was based on Massachusetts’s 2006 healthcare reform effort, signed into law by then-Governor Mitt Romney. Like Obamacare, Romneycare created a health insurance exchange and imposed an individual mandate — a requirement that all state residents purchase government-approved coverage or pay a fine.
Romneycare did drive down the uninsured rate. But costs have skyrocketed. Many patients struggle to access and pay for care. In a 2015 survey, 43% of insured adults in Massachusetts said that health care costs had caused a problem for them in the previous year. More than 37% of insured Bay Staters said they had gone without needed medical care.
The state’s insurance exchange, meanwhile, was so plagued by glitches that officials were forced to temporarily place 300,000 residents on Medicaid.
Romneycare’s foibles didn’t stop Democrats from foisting a version of it on the entire country in the form of Obamacare, all while congratulating themselves for their bipartisanship. Nevermind that they rammed the Affordable Care Act through Congress without a single Republican vote.
From the looks of it, United States of Care is adopting the same strategy. The group will look to establish a state-level single-payer system somewhere. Whether it succeeds — and it won’t — is unimportant. If Romneycare proved anything, it’s that even a failed state-level experiment can give political momentum for similar reform at the federal level.
Free marketers shouldn’t take comfort in the presence of a few “Republicans” on United States of Care’s board. Board member and former Senator David Durenberger, R-Minn., endorsed Hillary Clinton in the 2016 election. Former Senate Majority Leader Bill Frist, R-Tenn., has repeatedly praised Obamacare.
United States of Care might package itself as a bipartisan, pragmatic organization with no particular policy agenda. But it’s laying the groundwork for a government takeover of the nation’s healthcare system.