Pete Buttigieg proposes public option, says it could 'naturally' lead to 'Medicare-for-all'

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Buttigieg: Sometimes the boldest idea doesn't have to be the most polarizing idea

Democratic presidential candidate South Bend, Indiana Mayor Pete Buttigieg sits down with Bret Baier following the debate.

Indiana Mayor Pete Buttigieg unveiled a "Medicare for all who want it" plan that would offer a government-backed option for consumers, alongside price controls geared toward protecting people who maintain their private plans.

The plan, released on Thursday, represents an attempt by Buttigieg to distance himself from other Democratic 2020 candidates' "Medicare-for-all" plans that would effectively kick Americans off their private insurance. With a price tag of $1.5 trillion over a decade, Buttigieg, of South Bend, claims to guarantee universal care like Sens. Elizabeth Warren, D-Mass., and Bernie Sanders, I-Vt., while bolstering subsidies for low-income individuals.

The campaign says a Buttigieg administration would pay for the public option -- which includes automatic and retroactive enrollment for anyone without a private plan -- by repealing Trump's tax cuts and seeking cost savings through administrative reforms.

"My approach isn’t just the right thing to do for Americans — it will bring us together rather than push us even further apart, so we can achieve our bold objective of universal affordable health care," he said in a Washington Post op-ed published Thursday.

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It's unclear how long Americans could maintain their private insurance under Buttigieg's plan, though, as he's already reinforced conservative fears about a public option providing unfair and ultimately destructive competition for private companies.

"If private insurers are unable or unwilling to offer better plans than they do today, competition from this public alternative will naturally lead to Medicare-for-all," he said.

Nina Schaefer, a senior research fellow at the conservative Heritage Foundation, was more certain the plan would inevitably lead to a single-payer system.

"The end result will still be the same. He's just doing it in what he perceives the American people will [see] as a more modest approach to it," she told Fox News.

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She argued that Americans would eventually lose their private health insurance as Buttigieg's plan, like others, implemented regulations, like automatic enrollment, designed to stunt competition from private companies.

"What they're trying to do is really crowd out the private competitors by using their regulatory power ... to make the advantage towards the government plan," Schaefer said. She added that Democrats would likely "create a plan that looks artificially less expensive but yet somehow can offer all the benefits that are far more generous than what the private market is offering. That in itself already seems too good to be true because it is."

Buttigieg's plan was just the latest of 2020 Democratic proposals to promise consumer protection at the expense of private enterprise. His plan promised a series of price controls and regulations that it said would prevent hospitals and insurers from charging exorbitant prices.

That included an outright cap on premiums at 8.5 percent of income, requiring in-network health care facilities to only use in-network providers, and blocking providers from charging more than twice what Medicare would for an out-of-network service.

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Ryan Young, a senior fellow at the Competitive Enterprise Institute, told Fox News that consumers would continue facing high costs even with reduced premiums. "Their lower premiums would not reduce health care costs, either. They would have to be made up for with some mix of higher taxes, increased debt, lower health care quality, slower innovation, and reduced availability. Price controls are not a free lunch," he said on Thursday.

Buttigieg would also intensify government monitoring of health care providers by beefing up federal anti-trust enforcement and forcing insurers to report on cost disparities surrounding mental health care.

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Buttigieg will likely face criticism from progressives as his plan stops short of endorsing the kind of large-scale, government system that Sanders and Warren have endorsed.

Like former Vice President Joe Biden, Buttigieg's plan would build on the existing marketplaces set up by the Affordable Care Act while rolling back President Donald Trump's attempts to dismantle the Obama-era legislation. That policy famously earned him criticism from other 2020 candidates, who, in criticizing him, provoked a backlash by appearing to attack former President Obama's administration.