When President Trump declared in a USA Today op-ed that the Democrats' "Medicare for all" proposal would "outlaw" private health insurance, CNN's Jim Acosta indignantly tweeted that this was "false." But reading the text of the leading proposal by Sen. Bernie Sanders makes clear that Trump's op-ed was correct.
First, some background. Trump took to USA Today on Wednesday to attack socialized healthcare, an idea that is gaining traction among leading Democrats. I criticized the op-ed for pushing the talking point that such proposals would threaten traditional Medicare, because making this argument muddies the philosophical argument against government-run healthcare and does damage to the cause of entitlement reform.
But Acosta attacked the op-ed for mendacity:
This column may break the record for the number of falsehoods from a President ever published in a newspaper op-Ed. Just this tweet alone is false - “outlaw private health care plans” and “letting anyone cross our border” Huh? Fact check: false and false. Come on USA Today. https://t.co/1SPKMztmJL— Jim Acosta (@Acosta) October 10, 2018
Now, here we have one of those instances in which a tweet from USA Today is using shorthand for something that's described in more detail in the article. The op-ed says, "It is right there in their proposed legislation: Democrats outlaw private health plans that offer the same benefits as the government plan." This is, in fact, 100 percent accurate.
Sanders in 2017 offered a plan that was cosponsored by at least four other potential Democratic presidential candidates: Sens. Elizabeth Warren, Kirsten Gillibrand, Cory Booker, and Kamala Harris. These senators occupy five out of six of the top slots in a power ranking of the 2020 field compiled by Acosta's CNN colleague, Chris Cillizza. So, it's fair to look to the bill as representing where leading Democrats want to head on healthcare.
When considering how the bill treats private insurance, it's worth drawing a distinction between how it would handle existing private plans and future private plans.
It's crystal clear the bill would eliminate every existing private insurance policy within four years, which would mean about 180 million individuals would have to give up the insurance they currently purchase on their own or through their employers.
Here's how it does it:
Section 105 of the bill would require "the automatic enrollment of individuals at the time of birth in the United States and at the time of immigration into the United States...."
Section 106, subsection (a) of the bill says that benefits would kick in "on January 1 of the fourth calendar year that begins after the date of enactment...." This date is significant, because the same section allows that individuals under 19 (who are eligible for the new government plan sooner) "may opt to maintain ... private health insurance coverage ... until the effective date described in subsection (a)." In other words, within four years, Americans can kiss their current healthcare plans goodbye. Once the four-year period is up, we get to the issue of how the plan treats future private insurance.
Section 107 says that once the four-year period is up, it "it shall be unlawful for — (1) a private health insurer to sell health insurance coverage that duplicates the benefits provided under this Act; or(2) an employer to provide benefits for an employee, former employee, or the dependents of an employee or former employee that duplicate the benefits provided under this Act."
Now, it is true that later in the section, it says, "Nothing in this Act shall be construed as prohibiting the sale of health insurance coverage for any additional benefits not covered by this Act, including additional benefits that an employer may provide to employees or their dependents, or to former employees or their dependents."
So, there's a limited claim that can be made that in theory, the bill, after getting rid of all existing policies, would allow private insurers to offer some supplemental benefits.
But Section 201 details benefits the government plan would offer. The flip side is that this is a long list of benefits that private companies would be barred from covering: "(1) Hospital services, including inpatient and outpatient hospital care, including 24-hour-a-day emergency services and inpatient prescription drugs(2) Ambulatory patient services(3) Primary and preventive services, including chronic disease management(4) Prescription drugs, medical devices, biological products, including outpatient prescription drugs, medical devices, and biological products(5) Mental health and substance abuse treatment services, including inpatient care(6) Laboratory and diagnostic services(7) Comprehensive reproductive, maternity, and newborn care(8) Pediatrics(9) Oral health, audiology, and vision services(10) Short-term rehabilitative and habilitative services and devices."
That's a lot of stuff that would be off-limits for private insurers.
So, to sum up, the plan sponsored by five leading Democratic presidential contenders would automatically enroll every person in a government plan at birth, eliminate existing private insurance for 180 million Americans within four years, and bar insurers from covering a wide swath of medical benefits thereafter.
The slender reed that Acosta has to lean on, then, is that private insurers would still be allowed to offer plans that cover a very limited range of coverage. But given his overheated response and "false" declaration without any explanation, and given that he was quoting a USA Today tweet that teases an op-ed which describes the issue accurately and with more specificity, there's no reason to give him the benefit of the doubt.