Why can't California and New York make their own medicare for all?
Why can't California and New York make their own medicare for all?
I want to know why I'm wrong- because this question has been eating at me for years- and I secretly blame the Democrats for all of the health insurance problems.
Why can't California and New York bind together in an interstate compact, and create medicare for all of their citizens?
California and New York have GDP's above most other countries in the world. In general, democrats hold majorities. Tell me why I shouldn't blame the democrats for:
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Doing Obama care half assed, when something like 80% people wanted a public option.
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Not just doing it themselves. For instance even NYC by itself has a GDP above Denmark, and NYC is filled to the brim with the super rich.
New York State Medicaid is basically that, if you make under $28,000 a year or something like that. I was on it for a while. It’s good. everything is free.
The only problem is that not every provider accepts it. But most in the city do.
I hate those arbitrary cut offs for aid. Oops, you got a raise and now make $28,100 sorry no more medicare. It locks people into low paying jobs because if they make too much, they instantly loose all the benefits that their little raise doesn't match.
if we're not going to do free-for-all, it should at least be on a very large scale,
make less then 28k = 100% covered,
29, 99% covered
30, 98% covered
...
All the way up to when 128k = 0% covered
(You'd have fix healthcare prices too, procedures/medicines are priced so insurance looks like they are doing you a favor "you only had to pay $700 for this $25,000 procedure and the $600 follow up medicine will only cost you $100 a week")
ITT: people who don’t understand that Medicaid is not Medicare, and that means-testing means a service isn’t “for all.”
Editing to add: Medicaid is funded mostly by the federal government, 69% vs 31% funding from the state. So even if it wasn’t means-tested (one has to have an income below a certain amount, or be disabled to a certain degree before qualifying) it would not meet OP’s definition, a single payer health insurance system funded by the state.
To answer OP’s question, a state funded single payer health insurance program would likely run afoul of the Commerce Clause of the constitution which states the federal government has jurisdiction over interstate commerce. UHC, Aetna, and other nation-wide insurance companies would absolutely sue over the state programs interfering with their right to conduct interstate commerce, and they would almost certainly win, even without a hard right SCOTUS like the current one.
A few reasons:
- States are not currency sovereigns in that they do not create and control their own currency. All the money the state uses come from revenues they collect in taxes, fees, sales, etc. This is not the case for a national government, which creates all the money it needs for whatever it wants to spend money on. This gives the national government a lot more spending power than any state could possibly have, regardless of the state's GDP.
More importantly, though,
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All states except Vermont have statutory or (state) constitutional requirements to have a balanced budget every year. This means they cannot run a budget surplus or deficit. Any surplus has to be spent or returned to taxpayers and any deficit needs to be resolved that year. This makes it incredibly difficult to run large programs like a M4A over time. When the state runs into a budget shortfall, the M4A system would be the first on the chopping block.
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Insurance companies fight HARD against anything that hurts their business. This is specifically why Obamacare (the ACA) didn't include a public option despite Obama campaigning hard for a public option in the 2008 election. Insurance companies got their stooges in the Democratic Party to kill the public option when the ACA debates were going through Congress. They do the same in states when states try to do something about the healthcare industry. And if insurance companies publicly talk about a proposed bill causing them to raise rates or pull out of a market, that's a huge political stick to swing.
It may sound unbelievable, but I got the closest to MC4A after moving to a deeply red state. I thank the coop that was able to hook it up with it! But the type of coverage I have currently should be available to everyone without the need for a lucky expert.