Gov. Jay Inslee and Democratic lawmakers Tuesday announced proposed legislation for a new “public option” health care plan under Washington’s health insurance exchange. “We are proposing to the state Legislature that we have a public option that is available throughout the state of Washington so that we can increase the ability to move forward on the road to universal health care in the state of Washington,” said the governor, who is considering a run for president in 2020.

New York City Mayor Bill de Blasio (D) on Tuesday issued a bold guarantee of affordable health care for every resident, thrusting the nation’s largest city to the forefront of debates over universal health coverage and immigrant rights.

The promise is aimed at 600,000 New Yorkers who lack insurance because they can’t afford it, believe they don’t need it, or can’t get it because they are in the country illegally.

The announcement makes New York the second U.S. city to attempt to provide health care to everyone living there, coming about a dozen years after San Francisco pioneered the idea with a more limited promise. 

After dismissing for years the idea that Democrats’ health care plans would lead to a government takeover, new House Budget Committee Chairman John Yarmuth on Tuesday asked Congress’ top economist to sketch out the options for a government takeover. The Kentucky Democrat also implicitly sketched out the political game plan: enact socialized medicine before patients and taxpayers understand what they’ll be losing.

People 65 and older accounted for over one third of U.S. medical spending. Yet despite the fact that government pays for 65% of the elderly’s medical expenses, the burden of health spending (out-of-pocket expenses as a percentage of income) is much higher among the elderly than among those below age 65. You might suppose that a policymaker in 2008 would look at these data and conclude that if there is a crisis in affordability within the U.S. population, it lies among the elderly. 

The Health Care Choices Proposal would block-grant to each state its federal share of health care funding. When combined with their own health care resources, states would have the authority to determine how best to help their unique populaces obtain insurance. This private-insurance based program would give patients more choices—at multiple price points—to customize a health insurance plan that works best for their unique situation. It would empower employers, families, and individuals with expanded choices and premiums up to 32% lower.

More than 12 million nondisabled, working-age Americans are enrolled in Medicaid. They receive medical care that is virtually free, and in most states they are under no obligation to work or seek work.

Sounds like a great deal.

Until you consider how much these “free” benefits may cost a recipient over the course of a lifetime. That could total more than $323,000 in foregone wages for men and over $212,000 for women, according to a study by the Buckeye Institute, an Ohio-based free-market think tank.