Medicare for All: An Answer to America’s Healthcare Problems?

The following slide presentation was presented by Tom White and Beth Williams at the General Meeting of the Gilmer County Democrats on 2019 June 20.  Links for more information are included at the end.


What is Medicare?

A single payer healthcare system in four parts:

  • Part A Hospital Insurance
  • Part B Medical Insurance
  • Part C Medicare Advantage
  • Part D Prescription Drug Insurance

Healthcare Plans of the 116th Congress

  • As of 5/15/19 ten plans have been introduced
  • Both a House and Senate Medicare for All plan
  • Medicare for America, a Public Plan with Opt Out
  • Four other Public Plan Options
  • Two Medicare Buy-In Plans for Older Americans
  • One Medicaid Buy-In Plan

Medicare for All  S. 1129

  • Introduced by Bernie Sanders 4/10/19
  • All Dem Senators (ex Klobachar and Bennett) running for President are Co-Sponsors
  • Replaces all private insurance, Medicare, Medicaid and CHIP for covered benefits
  • Tax financed, no premiums and limited costs. A true single payer healthcare plan
  • H 1384 introduced by Rep Jayapal parallels S1129 with some minor differences
  • Eliminates ALL private Plans
    • All medically necessary services plus
    • Dental, Vision, Hearing
    • Home and Community based long-term care services and support
    • Comprehensive reproductive services (No Hyde Limitations)
    • Financing

Appropriates current federal health spending offsets (e.g., for marketplace subsidies, tax exclusion for employer-sponsored health coverage, Medicaid matching payments for acute care services and Medicare) to the Universal Medicare Trust Fund.

Medicare for America  H 2452

  • A Public Program
  • Employers CAN offer qualified group plan coverage
  • Opt-Out for Employer to pay 8% of payroll for employees to be in this plan
  • Replaces Marketplace, Current Medicare, Medicaid and CHIP plans
  • No premiums for incomes under 200% of FPL
  • Does away with private insurance except for Qualified Group Plans, Advantage Plans and supplements
  • Includes the 10 ACA essential care
  • Basic coverage similar to Medicare for All
  • Cost sharing for those above 200% FPL
  • Beto O’Rourke’s choice of healthcare legislation

Public Plan Options

    • Keeping Health Insurance Affordable Act
    • Choose Medicare Act
    • Medicare –X Choice Act
    • CHOICE Act
    • Currently 4 plans
    • All are based on the ACA
    • All maintain the Marketplace
    • Subsidies are maintained or enhanced
    • 3 retain current private and public coverage
    • All maintain employer insurance if so offered
    • Provision for HHS to negotiate drug prices for Part D

Medicare Buy-in for Older Adults

  • S 470 Medicare at 50 Act
  • H 1340 Medicare Buy-in and Healthcare Stabilization Act of 2019
  • S 470 Medicare at 50 Act
  • H 1340 Medicare Buy-in and Healthcare Stabilization Act of 2019
  • Both plans – enrollees must be 50+
  • Enrollee must pay for Parts A, B & D
  • Both have subsidies and Cost sharing
  • Enrollees can enroll in a Medigap supplement plan
  • Enrollee can opt for Medicare Advantage Plans

Medicaid Buy-In

  • S489 & H1277
  • State Public Option Act
  • State OPTION to offer public plan based on Medicaid

Summary

  • Passage requires super-majorities in the Senate
  • Will have to control the house and have 60 votes in the Senate
  • Financing plans vary from sketchy to complex
  • ACA was instituted because Congress could not get a single payer solution passed when Dems had majorities in both houses

Click Here to download the PowerPoint Presentation.  The links offered at the meeting are below.


Where the Democratic Candidates stand on healthcare

Side-by-side comparison of Medicare for All Proposals

New York Times 18 questions to candidates

New York Times interactive interviews with candidates