Topics
More on Policy and Legislation

Medicare for All bill revived by House and Senate progressives

As a catalyst for the renewed push, lawmakers cited the lives lost during the COVID-19 pandemic.

Jeff Lagasse, Editor

Photo: John Baggaley/Getty Images

Sen. Bernie Sanders and other progressives in the House and Senate have resurrected a Medicare for All bill that would seek to use the federal program as a springboard to a single-payer health system.

Sanders (I-Vermont) was joined by Representatives Pramila Jayapal (D-Washington) and Debbie Dingell (D-Michigan), as well as 14 senators and 110 members of the House of Representatives.

As a catalyst for the renewed push for Medicare for All, the lawmakers cited the lives lost during the COVID-19 pandemic – about a third of which they claim was linked to a lack of health insurance – as well as the roughly 15 million Americans they say could lose Medicare coverage this year.

WHAT'S THE IMPACT

Implemented over four years, the Medicare for All Act would provide healthcare coverage to all Americans with no out-of-pocket expenses, insurance premiums, deductibles or copayments. That would include coverage for primary care, vision, dental, prescription drugs, mental health, substance use disorder, long-term services and supports, and reproductive healthcare.

Lawmakers said it would also reduce the cost of prescription drugs by allowing the federal government to negotiate with pharmaceutical companies.

According to the Congressional Budget Office, Medicare for All would save the healthcare system about $650 billion annually. A study by Yale epidemiologists published in The Lancet estimates that Medicare for All would save some 68,000 lives per year, while a RAND study found that moving to a Medicare for All system would save a family with an income of less than $185,000 about $3,000 a year, on average.

Despite these figures, most of the healthcare industry stands opposed to Medicare for All. Payers are against a plan that would gut private insurance, while hospital providers say a government-run health plan would ultimately result in lower reimbursement.
In previous Medicare for All attempts, AHIP has said it is against what it calls the one-size-fits-all government system for health insurance. Under current coverage, Americans have choice and control over their options and treatment, AHIP said.

Responding to the original 2019 bill introduced by House Democrats during the run-up to the presidential election, the American Hospital Association said Congress has a history of slashing provider payments for government health programs and that Medicare and Medicaid reimburse providers less than the cost of delivering care.

"America's hospitals and health systems are working with policymakers to help expand coverage and improve affordability for all Americans," said AHA EVP Tom Nickels in 2019. "However, we are opposed to 'Medicare for All,' as it would impede our shared goals. The AHA believes there is a better alternative to help all Americans access health coverage – one built on fixing our existing system rather than ripping it apart and starting from scratch."

In 2020, the American College of Physicians, which represents internal medicine doctors, broke ranks with its industry peers by endorsing Medicare for All along with an optional government plan.

The ACP's reasons were numerous, as the group said such a policy would lower administrative costs and reduce barriers to care access. Physicians are becoming increasingly frustrated with the paperwork that comes with having multiple insurers with multiple rules and documentation requirements.

THE LARGER TREND

Based on 2019 surveys in a HealthPrep Data Service report, optional Medicare for All was the most popular policy among respondents at 45.4%. Keeping the current private system intact came in second, at 33.3%, while a mandatory Medicare for All system garnered the least support, at 21.2%.

This suggests that, while there's public support for a shift to some form of universal healthcare, voting-age Americans are wary of a complete break from the current system. In short, a majority of voters reject mandatory Medicare for All, while a majority support a Medicare for All option.
 

Twitter: @JELagasse
Email the writer: Jeff.Lagasse@himssmedia.com