Election Day is 9 days away and Texas voters still don’t know who MJ Hegar is 
-- let alone her policy plans. The latter is a result of her deliberate 
Election Day is 9 days away and Texas voters still don’t know who MJ Hegar is 
-- let alone her policy plans. The latter is a result of her deliberate 
evasiveness toward deep dives into policy. 
 
“She’s been very vague because she’s trying to win over crossover voters while 
at the same time not alienating progressives,” Rice University political 
scientist Mark Jones told theDallas Morning News 
<[link removed]>
. Call it vague -- We say dishonest. And Texans aren't going to stand for it. 
 
Today we look at: MJ’s “Steppingstone” to Medicare-for-All
 
Like Joe Biden, MJ Hegar is sly about her plans for healthcare. Both rebuff 
being labeled as “Medicare-for-All” supporters, but then boast about their 
public option plan. But MJ tipped her hand on her long-term aspirations in an 
interview with theTexas Tribune <[link removed]> 
(49:20): “I do like Medicare and I do think a ‘Medicare for All’ model could 
work... “What I would like, at least, as a steppingstone, is a Medicare option 
for people.” 
 
The Biden-Hegar “Steppingstone” plan would eventually phase out private, 
employer-provided insurance for13.5 million Texans 
<[link removed]>
. MJ told theTexas Signal <[link removed]>: “Yes. 
I think they should be able to keep private insurance. I don’t think most 
people will choose to do that as this model grows and people realize how much 
better Medicare is.” (6/10/19) And at a May 2020 town hall 
<[link removed]> said: “And I think, at first, 
people need to be able to choose to stay on their private insurance if they 
choose to do that. But I don’t know why they would. But there is a perception 
problem that we have to overcome in this country, okay?” (5/20/20)
 
The Biden-Hegar steppingstone to M4A will result in:
 * Higher taxes
 * An overburdened Medicare system (threatening solvency for the 3 million 
Texas seniors 
<[link removed]>
 currently on Medicare)
 * Many rural hospitals to clos 
It shouldn’t surprise anyone that Hegar would use her so-called public option 
to push Texans toward M4A. In 2018, Hegartold the Texas Tribune 
<[link removed]> 
“single-payer is the future of our health care system.” (8:26) Furthermore, she 
said a “Medicare for All” model “could be great. 
<[link removed]>” (49:20)  
 
In December 2019, Hegar told Evan Smith of the Texas Tribune 
<[link removed]>
 she would pay for expanding Medicare by raising taxes: “So, there's a lot of 
ways that we're going to pay for it. First of all, I think that, you know, we 
keep increasing the deficit every time we grant tax breaks to the top, not even 
1%, 0.1%.” …  SMITH: “Are you going to raise taxes on people above a certain 
income level?” HEGAR: “I think taxes will go up on people above a certain 
income level.” 
 
SMITH: “Ms. Hegar, you artfully switched to the passive voice and I'm not 
going to allow it. ‘Taxes will go up’ is not the same as ‘I will raise taxes.’ 
Will you – you – vote to raise taxes on people above a certain income?” HEGAR: 
“I will insist people pay their fair share.” (12/11/19, 32:56)
 
If that wasn’t harmful enough, the Biden-Hegar “Steppingstone” M4A plan would 
have a devastating impact on Texas’ rural healthcare.More than a quarter 
<[link removed]>
 of hospitals in Texas are in rural communities. A single-payer government 
health care program paying Medicare rates wouldforce rural hospitals to close 
<[link removed]>
 or drastically scale back their services and staff. Those that remain open 
would have to forgo future purchases of new equipment and technologies, and the 
latest training for medical staff.
 
9 days to Election Day. Texans must be told of MJ’s sly plans.
 
Krista Piferrer
Press Secretary
Texans for Senator John Cornyn
 
The Biden-Hegar “Steppingstone” to Medicare-for-All
Joe Biden’s Public Option Plan Carries A Gross Ten-Year Cost Of $2.25 Trillion 
And An Estimated $800 Billion Added To The Deficit
 
According To An Analysis By The Committee For A Responsible Federal Budget, 
Biden’s Health Plan—Which Relies On A Public Option—Has A Gross Cost Of $2.25 
Trillion And Would Add $800 Billion To Deficits Over Ten Years After Offsets. 
“Vice President Joe Biden’s health plan has a gross cost of $2.25 trillion and, 
incorporating offsets, would add $800 billion to deficits over ten years under 
our central estimate. It would save $300 billion in our low-cost estimate and 
add $1.3 trillion to deficits in our high-cost estimate.” (“Primary Care: 
Estimating Democratic Candidates’ Health Plans,”Committee For A Responsible 
Federal Budget 
<[link removed]>
, 2/26/20)
 
Biden’s Plan Includes Increased Obamacare Subsidies And A Public Option For 
Those In The Individual Market Or With Employer Coverage. “Vice President Joe 
Biden proposes to expand the Affordable Care Act by increasing marketplace 
subsidies, adopting auto-enrollment, and offering a new public option available 
to those in the individual market or with employer coverage. Biden would also 
offer a new long-term care tax credit and increase funding for rural health and 
mental health services.” (“Primary Care: Estimating Democratic Candidates’ 
Health Plans,”Committee For A Responsible Federal Budget 
<[link removed]>
, 2/26/20)
 
“To Finance The Costs Of This Plan, Biden Would Enact Reforms To Reduce 
Prescription Drug Prices, Lower Other Health Care Costs, And Raise Taxes On 
Capital Gains And Ordinary Income For High Earners And Heirs.” (“Primary Care: 
Estimating Democratic Candidates’ Health Plans,”Committee For A Responsible 
Federal Budget 
<[link removed]>
, 2/26/20)
 
M4A’s Impact on Texas Healthcare
 
A 2019 Analysis By Guidehouse Found That The Public Option Could Place As Many 
As 55% Of Rural Hospitals, Or 1,037 Hospitals Across 46 States, At High Risk Of 
Closure. A new analysis of U.S. rural hospitals has found that offering a 
government insurance program reimbursing at Medicare rates as a public option 
on the health insurance exchanges created by the Affordable Care Act (ACA) 
could place as many as 55% of rural hospitals, or 1,037 hospitals across 46 
states, at high risk of closure. The rural hospitals at high risk represent 
more than 63,000 staffed beds and 420,000 employees, according to the analysis 
by Guidehouse Inc. Even those rural hospitals not at high risk of closure and 
the communities they serve face an increased threat. The availability of a 
public option could negatively impact access to and quality of care through 
rural hospitals’ potential elimination of services and reduction of clinical 
and administrative staff, as well as damage the economic foundation of the 
communities these hospitals serve.” (Jeff Goldsmith And Jeff Leibach, “The 
Potential Impact Of A Medicare Public Option On U.S. Rural Hospitals And 
Communities,”Guidehouse 
<[link removed]>, 8/7/19)
 
A 2019 Study By The American Hospital Association And Federation Of American 
Hospitals Found That A Public Plan Reimbursing At Medicare Rates Could 
“Compound Financial Stresses” And Potentially Impact Access To Care And 
Provider Quality. “For hospitals, the introduction of a public plan that 
reimburses providers using Medicare rates would compound financial stresses 
already faced by the sector, potentially impacting access to care and provider 
quality. CBO projects that between 40 and 50 percent of hospitals could have 
negative margins by 2025 under current law.7 Given that Medicare pays hospitals 
below their costs (e.g., the Medicare Payment Advisory Commission estimates 
that Medicare inpatient margins will be -11 percent in 2018), Medicare-X Choice 
would be expected to increase the number of hospitals with negative margins. 
While hospitals may attempt to shift some costs to commercial insurers, the 
ability to do this under a public plan may be limited because of the study’s 
projected significant take-up by those in the non-group market. Policymakers 
should have a clear understanding of potential effects on patient access, 
provider payment, the commercial insurance market, and ESI (desired as well as 
unintended) when considering proposals to expand Medicare coverage.” (Lane 
Koenig et al, “The Impact Of Medicare-X Choice On Coverage, Healthcare Use, And 
Hospitals,”American Hospital Association and Federation Of American Hospitals 
<[link removed]>
, 3/12/19)
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