How Biden's public health care option should work, according to the Biden-Sanders task force

Throughout his campaign, presidential candidate Joe Biden has made it clear that his health care plan is not Medicare for all.

Instead, he plans on building upon the Affordable Care Act (ACA) to create a public option while keeping private insurance for those who want it. His campaign created a joint task force with allies and supporters of Sen. Bernie Sanders, his former opponent in the Democratic primaries.

The task force released its recommendations in a 110-page letter on Wednesday, including a section on how to create a public option.

“Private insurers need real competition to ensure they have incentive to provide affordable, quality coverage to every American,” the task force stated. “To achieve that objective, we will give all Americans the choice to select a high-quality, affordable public option through the Affordable Care Act marketplace.”

The document stated that Biden’s public option should offer at least one plan without deductibles that’s administered by Medicare and cover all primary care without co-pays. It should also negotiate with doctors and hospitals for costs for other treatments, much like Medicare.

“In the midst of the COVID-19 pandemic and President Trump’s recession, Democrats will take action to expand coverage to those who need it, including the newly unemployed and the long uninsured,” the plan said. “When the public option becomes law, it will be available on the Affordable Care Act marketplace for all Americans to choose.”

Former Vice President Joe Biden speaks as Senator Bernie Sanders listens during a virtual event seen on Monday, April 13, 2020. (Photographer: Andrew Harrer/Bloomberg)

‘A distinct proposal’

According to Marc Goldwein, senior policy director at the Committee for a Responsible Federal Budget (CRFB), these policy recommendations are fairly consistent with a CRFB analysis from January 2020, which found that it would cost an estimated $2.25 trillion over 10 years.

The analysis also found that Biden’s health care plan would “reduce costs by $450 billion” and “raise $1 trillion through direct and additional offsets,” while adding $800 billion to deficits over 10 years.

“It’s possible having the public option with no deductible at all will push up costs some relative to our score, but that really depends on the payments rates and the co-pay scheme,” Goldwein told Yahoo Finance.

A sign on an insurance store advertises Obamacare in San Ysidro, San Diego, California, U.S., October 26, 2017. REUTERS/Mike Blake

A key component of these newly unveiled recommendations focuses on Medicare. For older workers, they wouldn’t have to wait until they’re 65 to enroll in Medicare, which is current law. Under these proposals, once they reach 60, they will have the choice of Medicare, the public option, or staying in their employer-sponsored plans.

Karen Pollitz, a senior fellow at the Kaiser Family Foundation (KFF), said that lowering the age of Medicare eligibility is a “distinct proposal,” noting that these recommendations at large “could give low-income workers access to more affordable coverage options than they may be offered at work.”