Senate Democrats, including several of the party’s presidential candidates, have savaged President Trump for proposing to reduceMedicare spending by several hundred billion dollars over the next decade.

Senator Kamala Harris of California said the proposed changes in Medicare “would hurt our seniors.”

Senator Elizabeth Warren of Massachusetts tweeted, “The Trump administration wants to cut hundreds of billions of dollars from the #Medicare budget, all while giving billionaires and giant corporations huge tax breaks.”

Democrats in the House of Representatives have put aside grandiose thoughts of Medicare-for-All and single-payer health insurance – at least for a day or two. Instead, they have introduced a new health plan with a more modest goal: making Obamacare work better.

It has three elements:

  • Expand health insurance subsidies to everyone. (Individuals are currently ineligible for help if they earn $48,560 or more.)
  • Create a national reinsurance pool to subsidize insurance companies that incur high costs.
  • Reverse Trump administration regulations that make it easier to obtain limited-benefit insurance.

So, what’s wrong with that? For starters, it uses taxpayer dollars to give money to rich people and insurance companies.

The Trump administration’s decision to ask a federal appeals court to invalidate the Affordable Care Act has given House Democrats a new opening to pursue what they see as a winning political strategy: moving past talk of impeachment to put kitchen-table issues like health care front and center.

The Democrats’ new bill aims to lower health insurance premiums, strengthen protections for people with pre-existing medical conditions and ban the sale of what Democrats call “junk insurance.”

Is there a health care deal that would meet the needs and solve the political problems of members of both parties in Congress?

It seems almost inconceivable. The only talk on the left at the moment is Medicare for all. On the right there is not much talk about any aspect of health care. But when pressed, Republicans would still like to abolish Obamacare. Neither party is going to get its wish any time soon.

Still, desperate times call for new thinking. As voters get tired of hearing promises that are never met and never will be met, politicians will feel increasing pressure to accomplish something.

There may be several companies selling health insurance in a given market, but we’ve previously found that most people generally enroll with one of a few companies. When that happens, it can mean less competition and higher premiums for that area.

We updated our work with more recent private insurance data. The overall story is similar: The 3 largest companies held 80% or more of the market in at least 37 states.

Available data on the Affordable Care Act insurance exchanges had similar trends. Three or fewer companies held 80% or more of the market in at least:

  • 46 of 49 exchanges for individuals
  • 42 of 46 exchanges for small employers

Surprise medical billing—cases in which patients are unexpectedly billed at highly inflated prices from providers who do not accept their insurance—has attracted policymakers’ attention. In this report, we outline the economic rationale for why markets have not eliminated this behavior and present policy solutions. We emphasize that much of this phenomenon can be solved via contract reforms that require health care providers to negotiate market prices among themselves. This strategy produces market outcomes and minimizes the risks associated with rate regulation. Targeted rate caps should be considered only in cases in which contractual reforms are not feasible.

If the president is looking for a government to blame for distorted U.S. drug prices, he need look no further than our own. The federal government requires manufacturers to pay rebates, grant discounts, and comply with various price-distorting directives across a range of programs.