Clinton's public option — not good for women
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Hillary ClintonHillary Diane Rodham ClintonMatt Gaetz ahead of Mueller hearing: 'We are going to reelect the president' What to expect when Mueller testifies: Not much McConnell challenger faces tougher path after rocky launch MORE, campaigning to be America’s first female president, often touts her policy agenda as one that will help women and their families. However, her support for a “public option” for health insurance would ultimately do more bad than good for women, especially low-income women.

 

Many American women already depend on a public program for health insurance. In fact, the majorities of beneficiaries in Medicaid, Medicare, and Obamacare are women. Some on the left argue that this means these programs are helpful for women. But, on the contrary, these programs face serious problems that are harmful to the millions of women who depend on them.

 

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It is common knowledge that Medicaid patients have more restricted access to healthcare providers than patients with private health insurance, and inferior health outcomes. The reason is simple: Medicaid reimbursements to providers are well below those of private insurers, meaning many providers do not accept Medicaid patients or must limit the share of their patient pool with Medicaid.

 

For Medicaid beneficiaries, this often means it is difficult to get a timely doctor’s appointment.  Medicaid patients often end up seeking care for non-acute medical problems in an emergency room, where they cannot be turned away.  When they are seen, sometimes their health issue has progressed to a point that they face a less favorable prognosis and require more serious treatment.

 

Obamacare’s exchange plans aren’t much better. The narrow networks offered in these plans similarly restrict where patients can access care and which providers they can see.

 

On the other hand, most senior citizens who use Medicare would say they are pleased with the program. Satisfaction surveys suggest that the program for the elderly is doing a better job serving beneficiaries, probably because Medicare reimbursement levels are higher than those in Medicaid.

Attempting to use Medicare’s high approval ratings as political capital, some democrats are proposing to expand Medicare “for all” as the “public option.”

They should study the impact of Obamacare’s Medicaid expansion, however, which is ultimately hurting the indigent poor, pregnant women, children, and others who long depended on the program before it was expanded.  The expansion added millions of childless adults up to 138 percent of the poverty level without addressing the access issue, effectively making the ratio of providers to patients worse.  That means that it’s become even harder for people to get appointments and the care they need.

 

Medicare’s financial situation is unsustainable.  Although today’s beneficiaries are (for the most part) able to access the care they need, tomorrow’s Medicare patients will pay the price. Medicare faces an unfunded liability of $32.4 trillion over 75 years (a conservative estimate), and the Part A Trust Fund is scheduled to run out of money in 2028. At this time, the program will only be able to fund 87 percent of benefits. The government can delay this inevitability, but they cannot deny it.

 

Americans should recognize that government does not have a good track record in the insurance business. Out-of-control costs, limited access, and inferior care — these are not coincidental outcomes, but inherent characteristics of government health programs.

Therefore, we should expect a “public option” in health care to offer more of the same. Low-income women and other marginalized groups would inevitably become the lion’s share of enrollees, only to experience substandard care once in the government program.  Public systems always result in two tiers: those trapped on the public side, and others who are lucky enough to have the resources to escape to or remain on the private side.

Instead of expanding the government’s role, we should focus on moving as many women (and men) into health plans where they will experience the best access and outcomes — private insurance plans. To do this, we must focus on the main obstacle between customers and these plans, which is cost. Reducing mandated benefits and other unnecessary regulations would be a good first step. Offering tax relief to those who buy insurance on their own would also make private plans more affordable.  

If Clinton and other democrats pushing a new public option for health care really wanted to help low-income women and their families, they’d start by addressing the problems in the government programs that are already failing so many. Women certainly don’t need yet another substandard “option.” Clinton and others should instead focus on making the best care our country has to offer available to everyone by fostering an affordable, competitive private marketplace.

Hadley Heath Manning is the director of health policy at the Independent Women's Forum and a Tony Blankley Fellow for the Steamboat Institute. 


The views expressed by contributors are their own and not the views of The Hill.