Sen. Murray, Rep. Pallone Announce Plans to Develop a Public Option Proposal to Lower Health Care Costs

WASHINGTON, May 27 -- Sen. Patty Murray, D-Washington, chair of the Senate Health, Education, Labor and Pensions Committee, issued the following news release on May 26, 2021:

Senator Patty Murray (D-WA), Chair of the Senate Health, Education, Labor, and Pensions (HELP) Committee and Congressman Frank Pallone, Jr. (D-NJ), Chairman of the House Energy and Commerce Committee, announced their plans to develop legislation to establish a public option for health coverage to lower health care costs and help families get quality, affordable health care. The Chairs issued a Request for Information (RFI) today as they begin to work with their colleagues who have put forward public option proposals of their own to craft new comprehensive legislation.

"This pandemic has underscored why it's so important to patients, families, and communities across the country that health care is truly a right, not a privilege. No one should suffer or die because quality health care was too expensive or too hard to get. We believe we must take bold steps to lower health care costs and move toward universal coverage by creating a federal public option available to everyone--and a clear majority of Americans agree. A federal public option will help guarantee that no matter where you live, who you are, or what your income--if you live in America, you can get the quality health care you need without worrying about cost," said Murray and Pallone.

"We're grateful to our colleagues who have already put forward thoughtful proposals on dramatically expanding coverage--and President Biden who has always been clear that this is a priority for his Administration. We look forward to working with everyone in the weeks and months ahead as we work to craft bold legislation and finally getting this done for families across the country."

Murray and Pallone sent an RFI letter to the public today requesting their input as the Committee leaders begin to draft comprehensive public option legislation. The Committee leaders requested responses by July 31th, 2021.

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Read the letter below:

May 26, 2021

To All Interested Parties:

We write today requesting information on design considerations for legislation to develop a public health insurance option. We believe bold steps are necessary in order to achieve universal coverage and lower health care costs. As we work to craft legislation, our priority is to establish a federally administered public option that provides quality, affordable health coverage throughout the United States. We request information on the public option's key design considerations, including how it can lower the cost of health care for American families and dramatically expand coverage.

Our goal in establishing a federally administered public option is to work towards achieving universal coverage, while making health care simpler and more affordable for patients and families. The Affordable Care Act resulted in historic gains, providing health coverage to approximately 20 million Americans./1 The number of uninsured individuals decreased from about 46.5 million in 2010, to a historic low of approximately 26.7 million in 2016./2 Beginning in 2017, the Trump Administration reversed these trends, and the number of uninsured individuals climbed to 29.6 million in 2019./3 There were approximately 30 million uninsured individuals at the outset of the coronavirus disease of 2019 (COVID-19) outbreak./4 While the Biden Administration has taken a number of steps to expand coverage, including opening a special enrollment period that enabled over one million people to sign up for coverage on the Federal Marketplace alone/5, tens of millions of American still remain uninsured or underinsured.

In addition to expanding coverage, our goal is to develop a public option that lowers health care costs for American families. According to a survey by the Kaiser Family Foundation, 26 percent of U.S. adults struggle with paying for medical bills, and half of U.S. adults reported skipping some type of health care due to the cost./6 The same survey found that individuals with employer-sponsored insurance also reported experiencing difficulty affording their health care or health insurance./7 According to another survey by the Commonwealth Fund, 43 percent of U.S. adults are inadequately insured, and half of uninsured or underinsured adults reported problems paying medicals bills or paying medical debt over time./8 That survey found insured Americans also reported cost-related problems getting necessary care. Additionally, out-of-pocket costs and deductibles have grown faster than income, taking up a larger share of U.S. household incomes./9 According to recent polling, nearly 80 percent of American voters believe reducing health care costs should be a high priority/10, and seven in ten Americans support a public health insurance option./11

Health care affordability remains a challenge for many American families despite the fact that the United States spends more on health care than any other country/12, and health care spending in the United States is nearly double the average amount spent by other comparable high-income countries on a per-person basis./13 Additionally, there is not clear evidence that overall quality of care is as proportionally higher in the United States./14 The United States experiences worse health outcomes than other comparable high-income countries,/15 and, according to one study, the United States has the lowest life expectancy, higher suicide rates, higher chronic disease burden, and Americans visit physicians less frequently./16 Yet in 2019, U.S. health spending had well over doubled to $3.8 trillion from $1.4 trillion in 2000, and health care spending growth has outpaced the growth of the U.S. economy./17

We request information on public option legislation that would expand quality coverage to more Americans, improve affordability for families, and lower health care costs. As we work to draft bold legislation, our goal is to ensure that every American has quality affordable coverage regardless of income, age, race, disability, or zip code.

In light of these goals, please respond to the following questions:

1. Who should be eligible for the public option? Should a federally administered plan be available to all individuals or be limited to certain categories of individuals (e.g., ACA Marketplace eligible individuals, private employers and individuals offered employer coverage)?

2. How should Congress ensure adequate access to providers for enrollees in a public option?

3. How should prices for health care items and services be determined? What criteria should be considered in determining prices?

4. How should the public option's benefit package be structured?

5. What type of premium assistance should the Federal government provide for individuals enrolled in the public option?

6. What should be the role of states in a federally-administered public option?

7. How should the public option interact with public programs including Medicaid and Medicare?

8. What role can the public option play in addressing broader health system reform objectives, such as delivery system reform and addressing health inequities?

Thank you for your attention. Please direct responses and questions to Saha Khaterzai with the House Committee on Energy and Commerce at [email protected] and Colin Goldfinch with the Senate Committee on Health, Education, Labor, and Pensions at [email protected] by July 31, 2021.

View the signatories and footnotes at https://www.help.senate.gov/imo/media/doc/Public%20Option.2021.5.26.Letter%20for%20General%20Public.pdf