Utah Rep. Ben McAdams is no fan of Medicare for All — says focus should be on access

While progressive presidential candidates pitch Medicare for All as a solution to the nation’s health care dysfunction, Rep. Ben McAdams is saying the focus should be shifted — to access for all.

The state’s only congressional Democrat says health care is among the top concerns of the 4th Congressional District constituents he meets during open house and town hall events. Many are frustrated by high drug prices or the costs of medical care more broadly, he said.

While he agrees that there is major room for improvement in the nation’s health system, McAdams said he’s not in favor of Medicare for everyone, such as the plan being pushed by Sen. Bernie Sanders, the candidate who has received more campaign money in Utah than any other Democratic challengers.

Coverage is only a piece of the puzzle, McAdams said, and doesn’t translate into universal medical access, which he argues is the better goal.

“Just because you have health insurance doesn’t mean you have a doctor available to you,” the freshman lawmaker said Tuesday during a Salt Lake Tribune Editorial Board meeting.

Medicare for All refers to a government-run health care program that would replace all other public and private insurance plans and extend coverage to all Americans, paid for largely with a tax increase.

Although McAdams supports driving down exorbitant drug and treatment costs, making medical care completely free to patients might not be the best approach, he said. At times, patients can choose a less-expensive medicine or forgo an unnecessary test, but they have little reason to do so if they’re not chipping in financially, he said.

“If people care about the cost of their health care, they make informed decisions,” he said.

The absence of that individual incentive skews the marketplace toward “anti-competitive monopolies” that weaken the overall health system, he argued.

McAdams said the House has passed some legislation recently to improve health care across the nation. For instance, his chamber in May approved a measure that seeks to prohibit “pay-for-delay” agreements in which a brand-name drug maker will pay a generic manufacturer to keep a generic drug off the market.

This provision appeared in a larger package, now stalled in the Senate, aimed at lowering drug costs and shoring up the Affordable Care Act.

McAdams said he’s also intrigued by reinsurance programs that states such as Oregon and Maryland have implemented to help buffer the impact of especially costly health claims.

“If you have people with expensive illnesses, then it can break the back of an insurance and risk pool,” McAdams said.

Reinsurance programs work by spreading these risks more broadly and providing funds to health insurers covering these large claims, and McAdams said he believes the concept has shown promise in states that have embraced it.

On Tuesday, McAdams declined to pick a favorite in the Democratic presidential primary and said he’s not ready to dive into his own campaign, either.

He narrowly won the 4th District from former GOP Rep. Mia Love last year, and Republicans have already started lining up to reclaim the seat for their party; Utah Senate Majority Whip Dan Hemmert, Kathleen Anderson, Jay McFarland, John Molnar and, reportedly, state Rep. Kim Coleman have entered the running.

McAdams acknowledged he’s been doing some fundraising but said he’s waiting until next spring to begin campaigning in earnest.