Soaring prescription drug prices anger millions of Americans. The original ACA actually contains an obscene provision that prohibits Medicare from negotiating bulk discounts for seniors. Democrats should insist that Medicaid and Medicare gain the power to negotiate bulk discounts, and enable insurance companies in the exchanges to buy prescription drugs at the same price.
3. A Public Option
Democrats should seek to bolster the exchanges not by shoveling more subsidies to the insurance companies, but by creating a public option to insure competition in every county. The public option could be designed simply to provide subsidies for people on the exchanges to buy into Medicare. At minimum, consumers with no or one supplier in their county should be allowed to purchase insurance from the exchanges that members of Congress use.
4. Subsidize Consumers, not Insurance Companies
The Price of UnityDemocrats should make plans more affordable, not by weakening protection of pre-existing conditions or strong standards on required treatment, but by boosting subsidies to consumers, either raising the income levels for eligibility for subsidies or increasing the subsidies themselves. Democrats should also champion aggressive proposals to expand resources to treat the opioid epidemic that is spreading with catastrophic effect.
Democrats have remained remarkably unified in opposition to the GOP's obscene bills to "repeal and replace" Obamacare. This will be harder to sustain once bipartisan negotiations open up.
McConnell is no fool. He'll seek to pick off the fewest number of Democrats, and make only the fewest concessions he needs to get a bill passed. Meetings have already begun with more conservative Democrats, like Heidi Heitkamp (D-ND) and Joe Manchin (D-WV).
Democrats should caucus now, work to unify around a proposal and seek the support of a handful of Republicans. Democratic lawmakers should make certain that they don't end up signing off on conservative reforms that price millions out of health care.
If Republicans truly want support from their colleagues, Democrats must demand clear, popular amendments that demonstrate they are committed to extend the right to affordable health care, not reduce it.
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