Democratic presidential candidate Pete Buttigieg unveiled a health care proposal Friday that would offer "Medicare for all who want it” while maintaining the current system of private health insurance.
Buttigieg says he wants to “make progress toward universal health care” by building on the Affordable Care Act. The South Bend, Indiana, mayor proposes to provide more generous subsidies to low- and middle-income consumers in the ACA marketplaces and to make a publicly-run “Medicare-type insurance plan” available to all. The goal is to boost enrollment by reducing the out-of-pocket cost of existing plans while using the government-backed health care plan to generate more competition between insurers.
A focus on rural America: Buttigieg’s proposal is especially focused on health care in less densely populated parts of the country, where providing affordable insurance and services has been particularly problematic. "The fact is if you live in a rural part of our country, you are more likely to get sicker and die younger than people living in cities," the proposal says. "That is wrong."
To improve insurance coverage and service availability in rural areas, the candidate proposes numerous new policies, including the expansion of student loan forgiveness programs for health care providers, more aggressive recruitment of immigrant doctors, increased Medicare reimbursement rates and more federal support for medical training outside of urban areas.
In order to promote greater use of digital communications in health care, Buttigieg proposes to “massively expand coverage of high-speed broadband Internet across the country” while investing in new facilities for telehealth. And to address persistent inequalities in health outcomes based on geography as well as race, Buttigieg proposes to designate special “health equity zones” that receive targeted investments to reduce disparities.
An incremental approach: The proposal to add a public option to the existing health care system places Buttigieg among the more moderate Democratic candidates, closer to former vice president Joe Biden than to Sens. Elizabeth Warren and Bernie Sanders, who are calling for a universal health care system modeled on Medicare that would eliminate private insurance. The Washington Post’s Paige Winfield Cunningham said the proposal “puts the mayor squarely in the camp of Democrats who’d rather focus on getting coverage to the remaining uninsured Americans rather than overhauling it for everyone else.”
But private insurers are put on notice: While Buttigieg has outlined a plan that keeps private insurers at the center of the health care system, he also makes it clear that current system needs to improve significantly. “If corporate insurers don’t lower costs to deliver something dramatically better than what is available today,” his proposal warns, “competition will lead us towards Medicare for All.”
