The Democratic leadership in the U.S. House of Representatives, and probably in the U.S. Senate, understands that the country is not ready for and doesn’t want a single-payer health care system. The leadership is sympathetic toward Democrats who do support socialized medicine and, truth be told, have the same goal – just a more incremental approach to nationalized health care.

Yesterday, Democrats in the House released their proposal to “strengthen” the Affordable Care Act, also known as Obamacare. (here) The items included are:

• An increase in tax credits or premium support for people purchasing health insurance in the Obamacare exchanges.
• A resurrection of cost-sharing reductions to decrease out-of-pocket expenses for these same people.
• A ban on the use of short-term, limited-duration health insurance plans.
• More money for advertizing the insurance plans in the Obamacare exchanges.
• An allocation of more taxpayer money for state health programs.
• An allocation of taxpayer money for a national re-insurance program.
• A restriction on the use of state Obamacare waivers.

The proposal is not yet in bill form, so we don’t know exactly what items will make it to a final vote. Rest assured, the Republican-controlled U.S. Senate will not pass the bill.

The Obamacare exchanges are in a death spiral, simply because of adverse selection. Young, healthy individuals do not want or need health insurance plans that contain benefits they won’t use. These people are opting to not buy insurance. That leaves older and sicker individuals in the exchanges, where premium prices must go up to cover their health-related expenses. As prices go up, insurance becomes even less attractive for healthy people.

The only way to save the exchanges is with more taxpayer money. This is exactly what the Democrats are proposing. In addition, the bill would give the federal government more control, would restrict state actions, and would offer fewer reasonable options for the young and healthy.

Simply by the way the ACA was written, it was predictable that the exchanges would collapse unless more money was allocated. Unfortunately, this is the usual course for government entitlements – throw more money at the problem. In the case of health care, the country may very well wind up with a single-payer system by default, which, tragically, is the ultimate goal of the political left.