Drew Altman: Medicare for All Would End States’ Role in Health Care

And that could present a problem because states have been used as laboratories for health care system innovation.

A lot of attention in the debate over Medicare for all focuses on the real possibility that such a system would do away with private health insurance, where about 155 million Americans, or nearly half the total population, obtain coverage. Writing in Axios, Drew Altman, CEO of the Kaiser Family Foundation, points that Medicare for all (Altman focuses specifically on the plan put forward by Sen. Bernie Sanders) would also put an end to Medicaid and the Children’s Health Insurance Program, as well. Medicaid, funded jointly by states and the federal government, and CHIP cover about 73 million people.

“States would reap huge savings,” writes Altman. “Medicaid is the single largest item in most state budgets.”

On the other hand, “state Medicaid programs are leaders in experimenting with delivery and payment reforms, efforts to control drug costs, and addressing social causes of ill health, such as poverty and poor housing,” writes Altman. “All of those projects would still be important in a single-payer world.”

These are just some of the considerations lawmakers and the public should consider when looking at a Medicare for all plan that eliminates Medicaid. At the very least, argues Altman, the fate of Medicaid should be part of the discussion.