SEATTLE (Good Medical) – Spurred by the November elections, US Democratic leaders are quick to deliver on their biggest campaign promise: expanding access to health care and making it more affordable.

The first full week of legislative sessions and swearing in of governors was followed by a wave of proposals.

In his initial actions, the newly-elected California governor, Gavin Newsom, announced his intention to extend Medicaid to those who were living illegally in the country until the age of 26, to put in place Implement a mandate stating that everyone must take out insurance or face a fine, and consolidate the state's prescription drug purchases as this will significantly reduce costs.

Washington Governor Jay Inslee has proposed a public health insurance option for people who are not covered by Medicaid or private employers and have trouble paying for policies in the private market.

Democrats in several states where they now control the legislature and the governor's office, including New Mexico, are considering ways for uninsured people who earn too much to qualify for Medicaid or another subsidized coverage, to buy Medicaid policies.

And in the most populous city in the country, New York Mayor Bill de Blasio announced a public plan to involve uninsured people, already treated in city hospitals, in primary care.

All of this is consistent with the main theme of the Democratic candidates promoted in the 2018 election campaign.

They extolled the benefits of President Barack Obama's revamping of health – including protections for those already affected, allowing young adults to continue to benefit from their parents' health insurance policies and expanded options. for low-income Americans. At the same time, they described Republicans as seeking to eliminate or significantly reduce health options and protections.

"Once you give something to someone, it's pretty difficult to take it off, and I think we find that support for the (Affordable Care Act) has increased over the last two years. past years, "said Eileen Cody, representative of Washington House. who leads the public option proposition of the state.

The actions also stand in the way of steps taken by the Trump administration and congressional Republicans to undermine the Affordable Care Act.

The GOP tax law removed the individual mandate, which aimed to stabilize the insurance markets by encouraging younger and healthier people to take out policies. And last summer, the Trump administration announced that it would freeze payments as part of an "Obamacare" program that protects insurers whose patients are sicker from financial losses. This move should help increase premiums.

Democratic proposals do not provide universal health care, a goal of many Democrats but also a difficult goal to achieve because of its cost. In recent years, California, Colorado and Vermont have all considered and then abandoned their attempts to create state-run health care systems.

Yet many Democrats are eager to take action that brings them closer to that.

"This is not just a moral right," Inslee said in announcing his proposal for a public option last week. "It's an economic wisdom, and it's very possible."

Some legislators in Colorado, where Democrats now control the legislature and the governor's office, are proposing a state-run health insurance scheme similar to that announced by Inlsee. It would affect those who are not eligible for federal assistance or who live in rural areas with little choice in health care.

Both states plan to rely on their agencies that run Medicaid, the federal-state program that provides health coverage to about one in five Americans. Republicans are skeptical about whether states can afford it because they are already paying some of Medicaid's costs.

"It's about getting the government to compete in the private market. Medicare for all will be priced, "said Washington State Representative Joe Schmick.

Taking progressive steps to increase coverage options and make health care more affordable may be a better strategy than pursuing an expensive and complicated universal coverage proposal, said Katherine Hempstead, Senior Policy Advisor at Robert Wood Johnson. Foundation.

"Everyone wants to pay less for health care," she said.

Democrats now have more weight to experiment. Messages from the health care campaign helped them to overthrow seven governor seats to increase their number to 23 across the country and win back several legislative chambers. They acquired full control of the government of several states, including New York and Nevada.

This power will allow them to consider extensions of the health system that Republicans have resisted.

In Nevada, for example, the state legislature, which is controlled by democracy, passed a bill in 2017 that would have allowed anyone to take out a Medicaid insurance plan, similar to the option proposed in New Brunswick. Mexico. But former governor Brian Sandoval, a Republican, vetoed it.

The new governor, Democrat Steve Sisolak, is forming a committee to look at options for health care, including the option of requiring everyone to have insurance. In addition to the California proposal, this mandate is already in force in Massachusetts and New Jersey, followed by Vermont in 2020.

This is a similar dynamic in New Mexico, where Democratic lawmakers have been talking for years about allowing people, including non-citizens, to subscribe to Medicaid if they can not afford insurance otherwise.

Colin Baillio, policy director of health advocacy group Health Action New Mexico, said a bill was being drafted with the goal of getting it passed this year and putting it into practice. 2020. Optimism comes from the fact that the new Governor, Michelle Lujan Grisham, is a Democrat.

"People will need health care one way or another," he said. "We believe that health coverage is a good investment for our state."


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