House Democrats to Release "Medicare for All" Bill – No Price Tag

Progressive Democrats in the House will unveil on Wednesday the all-out Medicare for All bill, which will present the most detailed detailed plan of how they will upset the health system to ensure coverage for every American – a long-sought-after progressive dream that is already shaping the Democratic Race to challenge President Donald Trump.

The bill, co-sponsored by just over 100 Democrats in the House, does not include specific awards or proposals to fund the new system, which analysts say would cost tens of billions of dollars on a budget. decade. Washington State Representative Pramila Jayapal, the main sponsor, announced that she would issue a separate list of suggested funding mechanisms, including a new high income tax or mandatory contributions from the company. 39; employer.

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The proposal calls for a two-year transformation of Medicare into a universal single-payer system, eliminating almost all private health plans. It would also expand Medicare coverage to include prescription drugs, dental and vision services, as well as long-term care, without any deductions, premiums or deductibles – and would provide federal funding for abortions.

The bill fits into a furious debate within the Democratic Party about the breadth of its health care ambitions, pitting a progressive vocal base keen to make Medicare for All a crucial problem for 2020 against its moderate establishment, more cautious. The question remains open as to where the Democratic leaders will allow the bill to advance in the House, while the Republicans are calling for hearings on what they mock the "socialist" nightmare.

Advocates of Medicare for All believe that their 100-page bill is a meticulous roadmap for single-payer health care and hope that its unveiling will silence critics who dismissed the idea as a little more than a catchy slogan.

Republicans, eager to bring down Medicare for all, argue that the system it would cost taxpayers tens of billions of dollars and would force hundreds of millions of patients from their private plans to government-run coverage. Powerful health industry groups who joined the Democrats to help pass Obamacare nearly a decade ago also came together to fight against a concept that would revive the health system and threaten their business models.

Nevertheless, several Democratic presidential candidates have adopted Medicare for All as a political rallying cry over the past year, as polls show that the public is increasingly in favor of universal health coverage and left wider among Democratic voters. But aside from Senator Bernie Sanders (I-Vt.), Who introduced the idea of ​​liberal fringes into the mainstream of his 2016 presidential campaign, most candidates have avoided offering details that could spark criticism.

Recent surveys have revealed that the public sees the concept of a single payer system favorably. But this support erodes dramatically when voters learn that it would eliminate most private health insurance and could raise taxes. Republican lawmakers are confident that the policy will be pity Democrats in the 2020 elections, particularly among moderate suburban voters who helped the party resume its duties in the House of Representatives in November.

But progressive lawmakers, led by Jayapal and Sanders, are also confident that the public will adopt a single-payer plan if Democrats show enough vigor. They plan to pressure their fellow Democrats and contenders to 2020 to fully embrace the overhaul of the health care system that they say has left the American people behind.

Two house The committees will hold the first hearings on Medicare for all next month, but the leaders have made no other commitment to move the legislation forward.

The House bill largely reflects Sanders' Medicare for All bill in the Senate. Both bills argue widely for the feasibility of a costly transition that would reshape the Medicare program and make it a universal insurer.

But unlike the Sanders Plan, Jayapal's bill would allow the government to fund long-term care, a particularly expensive part of the health care system. The bill also provides for a two-year transition to a single payer, which is faster than Sanders' four-year bill.

In addition, the inclusion of an abortion coverage would eliminate the long-standing prohibition of federal dollars for the procedure in almost all cases. States would also be prohibited from excluding abortion providers such as Planned Parenthood, which some Red States have attempted to hunt for Medicaid.

Under the bill, a new government-funded coverage would become available at the end of the first year of transition for a large portion of the population: those currently enrolled in Medicare, people over 55 and under 19 years old. the program this first year, then the system would come into effect for everyone by the end of the second year. There are some exceptions for those covered by Veterans Affairs and the Indian Health Service.

Although the bill does not include cost estimates or specific funding, House progressives attempt to take into account the funding of such a restructuring.

The bill directs the creation of a national health budget requiring federal officials to negotiate annual payments to providers in advance. And, during the first five years, at least 1% of this huge budget would go to programs helping millions of displaced health workers through the creation of a single, government-run system, including the "replacement of "salary" and pension benefits. training.

The government would also be able to negotiate drug prices directly with pharmaceutical companies – a long-standing political priority for Democrats – and create a single list of covered drugs that encourages providers to use cheaper generics.

Advocates of Medicare for All have long argued that Americans would ultimately pay less with a single payer system, even with tax hikes, as they would no longer need to shell out premiums and pay the premium. -part, nor to be faced with thousands of dollars in unexpected medical expenses. expenses. According to the Journal of the American Medical Association, Americans pay almost twice as much for per capita health care as citizens of other industrialized countries and have worse health outcomes.

But skeptics dismissed the idea that Medicare for All would allow Americans to save money, largely because single payer proposals have not yet spelled out the money. The scale of the tax increases and the economic changes needed – a lot of these would hit the middle class and risk being put aside. health insurance support for all.

It is unclear when and if the Congressional Budget Office will evaluate the bill and allocate a price. During a phone conversation with reporters, a Jayapal staff member preemptively dismissed the Congress Keeper's ability to evaluate this bill, echoing the complaints made by the Liberal Republicans about Office forecasts.

Among the initial co-sponsors of the project are a range of progressive Democrats, from prominent high-profile students such as Representative Alexandria Ocasio-Cortez (DN.Y.) to important liberal pillars such as representatives Raul Grijalva (D -Ariz.) And Jim McGovern (D-Mass.), Chairman of the House Rules Committee. Massachusetts Representative Katherine Clark, Democrat in House No. 6 and second highest ranked caucus, also joined.

Despite the growing enthusiasm of the grassroots for the concept, the bill initially counts fewer co-sponsors than the 124 Democrats who joined a previous version of the Medicare for All bill last year, while the draft law was only a general overview of former representative John Conyers. (D-Mich.) Had been presented several times for years before his resignation in late 2017. Jayapal had taken over the law last year and had it rewritten and developed for months.

While the House and Budget Committees are scheduled to hold Medicare for All hearings starting in March, the bill did not spark firm commitments from the Energy and Trade Working Groups. and Ways and Means, which amendments are necessary for the bill to be presented to the House.

The Democratic establishment, anxious to vote on a policy likely to create divisions and which has no chance of becoming law under President Donald Trump, is pushing the caucus to focus on strengthening Obamacare and the protection of the helped the Democrats to reconquer the House in November. Some also have ideas for expanding government coverage to smaller groups, such as near-retirees, without completely changing the health system.