Can federally run state insurance exchanges lead to single payer?
Five wingnut Governors have said that they will not set up state run insurance exchanges, but will opt for the Feds to run their state’s exchanges. So, can this be a kind of backdoor for single payer? I’m honestly asking.
It will probably look more like the FEHB than like Medicare.
I agree. FEHB is a good model. Government involvement is limited to the standards/requirements, policy, and facilitating the selection, but they are not involved in the operational side of it. That’s between the insurance companies and the covered federal employee.
I don’t think that we will ever see a universal single payer (e.g. Canada). Some of that will be that people like their plan and don’t want or need to change. In fact, I like my plan (wish it were cheaper) so this open season I probably won’t change but I’ll go through the motions of the selection process anyway to see if I am missing anything.
Vermont is looking to use the ACA as a jumpoff to eventual single payer and I think that CA is looking at that possibility, although I believe that they further away than Vermont is. Vermont thinks that a small state should be leading the way and I think that Delaware could join them.
If CA goes signal payer and dramatically lowers health care costs there, then it will sweep the nation.
Lobbying will be furious in Sacramento… Furious!
And Vermont is looking very attractive.