Bernie Sanders unveils his new 'Medicare for All' plan.
Published April 10, 2018
WASHINGTON — Sen. Bernie Sanders of Vermont unveiled a new version of his "Medicare for All" plan on Wednesday, shaking up the 2020 presidential race by reopening the debate over his call to eliminate private health insurance.
"It is not a radical idea to say that in the United States, every American who goes to a doctor should be able to afford the prescription drug he or she needs," Sanders said. "Health care is a human right, not a privilege."
Four of Sanders' fellow senators and rivals for the Democratic nomination are set to sign onto the updated single-payer health care proposal. The bill's reintroduction promises to shine a light on Democratic presidential candidates' disparate visions for the long term future of American health care.
Under fire from President Donald Trump and Republicans for the astronomical price tag of Medicare for All, some candidates who support the plan tout it as one of several ways to achieve more affordable coverage and lower the number of uninsured people. Others who don't back it are instead focusing on safeguarding popular provisions of the Affordable Care Act, such as the one that protects coverage of pre-existing conditions.
"Of course, our No. 1 goal should be to make sure we keep in place those protections so people don't get kicked off their insurance," Sen. Amy Klobuchar, a Minnesota Democrat who isn't signed onto Sanders' bill, said Tuesday. "Then we also have to see the Affordable Care Act as a beginning and not an end."
Klobuchar supports a so-called public option, versions of which would allow Americans to buy into Medicare or Medicaid. Four other Democratic senators also running for president — Elizabeth Warren, Cory Booker, Kamala Harris and Kirsten Gillibrand — back Sanders' single-payer plan, which would replace the current mix of private and government health insurance in the U.S. with a new system run by the government. But they also have signed onto at least one version of a public option.
Warren pointed to "a lot of different pathways" to universal coverage during a CNN town hall last month: "What we're all looking for is the lowest cost way to make sure that everybody gets covered."
The debate is unfolding in the early stages of a Democratic primary in which some candidates have pointed to their support of Medicare for All to prove their progressive bona fides. But other Democratic contenders, including former Colorado Gov. John Hickenlooper, have criticized Sanders' measure as politically infeasible.
Under Medicare for All, Americans would no longer pay premiums or face insurance deductibles as the government-run system replaced private health insurance offered through employers, the mainstay of coverage for more than 160 million Americans.
Big tax increases would be needed to finance such a system. The transition is likely to be complicated, dismantling the private health insurance industry and making major changes for hospitals, doctors, drug companies and other medical providers.
"What our system does is get rid of insurance companies and drug companies making billions of dollars in profit every single year," Sanders told CBS News for an interview set to air Wednesday, adding that private insurance would largely exist solely for elective medical care such as cosmetic surgery.
With Sanders' idea returning to the forefront, Republicans have a fresh opportunity to slam his plan as too costly and unworkable.
"So-called 'Medicare for All' means private insurance for none, kicking 180 million Americans off of their current plans," said Kayleigh McEnany, spokeswoman for Trump's re-election campaign. "'Medicare for all' is a euphemism for government takeover of healthcare, and it would increase wait times, eliminate choice, and raise taxes."
She touted Trump's "free market policies" as a better alternative.
Trump has said he'll take up health care after next year's election, essentially making it a central campaign issue. And his administration is arguing in court for the full eradication of the Affordable Care Act, former President Barack Obama's signature health care law, often called "Obamacare."
Senate Majority Leader Mitch McConnell, R-Ky., warned in a Tuesday floor speech that the cost of Sanders' proposal "is so steep that even left-leaning analysts are quietly admitting that the tax burden is virtually certain to land on the shoulders of the middle class."
Sanders' office released a paper outlining options to pay for his last version of Medicare for All, estimated to cost upward of $1 trillion per year, although none of those options was included in the legislation. He and other supporters of Medicare for All have generally sidestepped the question of how they'd pay for their plan. Instead, they say it offers the best chance for the nation to get control over health care costs by eliminating profiteering. His newest edition of the bill also would cover long term care, an unmet need for most middle class families.
Several independent studies of Medicare for All have estimated that it would dramatically increase government spending on health care, in the range of about $25 trillion to $35 trillion or more over a 10-year period. But a recent estimate from the Political Economy Research Institute at the University of Massachusetts in Amherst suggests that the cost could be much lower.
Neera Tanden, president of the Center for American Progress Action Fund, noted the emphasis by most Medicare for All supporters on "multiple pathways" to universal coverage as a potential point of contrast and "fodder for debate" with Sanders, who is leading the Democratic field in early fundraising and is campaigning as a front-runner.
"I think it really matters what you say to voters," Tanden said. "That's the most important thing."
Her group has proposed a Medicare opt-out plan known as "Medicare for America," supported by former Texas congressman and Democratic presidential candidate Beto O'Rourke, which would allow people to choose to keep employer-sponsored insurance.
Earlier this year, a poll from the nonpartisan Kaiser Family Foundation found that Americans like the idea of Medicare for All but that support flips to disapproval if it would result in higher taxes or longer waits for care.
What’s New in Bernie Sanders’ New Medicare for All Plan.
Published April 11, 2019
Saying he wants to end the “international embarrassment” of the U.S. being the only wealthy country that doesn’t provide universal health coverage, Sen. Bernie Sanders (I-VT) released a new version of his Medicare for All plan Wednesday. The bill’s 14 co-sponsors include Sanders’ fellow presidential candidates Elizabeth Warren (D-MA), Cory Booker (D-NJ), Kamala Harris (D-CA) and Kirsten Gillibrand (D-NY).
The revamped health care proposal is similar to the plan Sanders released in 2017, though it adds a long-term care benefit for Americans with disabilities. Overall, the bill would transform the $3.5 trillion health U.S. care system by replacing private health insurance with a single-payer system that covers primary and preventive care, hospital stays, mental health, dental and vision services, and prescription drugs for all Americans.
“It is not a radical idea to say that in the United States, every American who goes to a doctor should be able to afford the prescription drug he or she needs,” Sanders said. “If every major country on earth can guarantee health care to all and achieve better health outcomes, while spending substantially less per capita than we do, it is absurd for anyone to suggest that the United States of America cannot do the same.”
Vox’s Sarah Kliff said Sanders’ plan “includes an exceptionally generous benefit package” compared the country’s peers, including Canada, which does not cover vision, dental or prescription drugs.
Here are some key features of Sanders’ plan:
Medicare for All would be phased in over four years, with the qualifying age falling by a decade each year.
In the interim, Americans would be given the option to buy into a publicly run health care program.
The Indian Health Service and the Department of Veterans Affairs would remain independent for at least 10 years.
There would be no premiums, deductibles or co-pays for health services, excluding prescriptions drugs.
Enrollees would face a $200 maximum co-pay for prescription drugs annually.
Medicare would be required to negotiate drug prices and create a drug formulary listing the medications that may be prescribed.
Providers would be paid under the existing Medicare fee schedule.
The program would be part of a new Universal Medicare Agency within the Health and Human Services Department.
Private insurers could provide only benefits not covered by the government, such as elective surgery.
Sanders left the big question – how to pay for his proposal – largely unanswered, although he did provide a list of suggestions, including a 4% tax on employees (exempting the first $29,000 in income for a family of four), a 7.5% tax on employers (exempting the first $2 million in payroll) and a new tax on “extreme wealth.”
The Trump campaign criticized the plan as a “government takeover of health care” and said that “free market policies” would be a better alternative. “So-called ‘Medicare for All’ means private insurance for none, kicking 180 million Americans off of their current plans,” said Kayleigh McEnany, spokeswoman for Trump’s re-election campaign. “‘Medicare for all’ is a euphemism for government takeover of healthcare, and it would increase wait times, eliminate choice, and raise taxes.”
The bottom line: The 2020 presidential election could turn on the question of health care, and with another iteration of his Medicare-for-All plan, Sanders has underscored his position as the leading progressive in the race for the Democratic nomination. The details of the plan may matter less than the simple fact that the two main U.S. political parties will likely offer voters a clear alternative on this defining issue.
Bernie Sanders: Spending ‘a lot’ on Medicare for All will save people ‘substantial’ money.
Sen. Bernie Sanders on Monday defended his Medicare for All plan, which has faced criticism from some of his 2020 rivals for its staggering price tag. The Democratic presidential candidate, who also said a recent heart attack has not slowed him down, joins Judy Woodruff to discuss health care, the difference between him and his progressive rival Sen. Elizabeth Warren and President Trump’s Syria decision.