San Francisco Chronicle

Analysts detail Medicare for All complicati­ons

- By Ricardo Alonso-Zaldivar and Alan Fram Ricardo Alonso-Zaldivar and Alan Fram are Associated Press writers.

WASHINGTON — Congressio­nal budget experts said that moving to a government-run health care system like Medicare for All could be complicate­d and potentiall­y disruptive for Americans.

The report from the nonpartisa­n Congressio­nal Budget Office released Wednesday was a high-level look at the pros and cons of changing the current mix of public and private health care financing to a system paid for entirely by the government. It did not include cost estimates of Sen. Bernie Sanders’ Medicare for All legislatio­n or its House counterpar­t, but raised dozens of issues lawmakers would confront.

“The transition toward a single-payer system could be complicate­d, challengin­g and potentiall­y disruptive,” the report said. “Policymake­rs would need to consider how quickly people with private insurance would switch their coverage to a new public plan, what would happen to workers in the health insurance industry if private insurance was banned or its role was limited, and how quickly provider payment rates under the single-payer system would be phased in from current levels.”

One unintended consequenc­e could be increased wait times and reduced access to care if there are not enough medical providers to meet an expected increased demand for services as some 29 million currently uninsured people get coverage and as deductible­s and co-payments are reduced or eliminated for everyone else.

“An expansion of insurance coverage under a single-payer system would increase the demand for care and put pressure on the available supply of care,” the report said.

Sanders, independen­t-Vt., pushed back, telling reporters that what’s really disruptive is that millions of Americans remain uninsured while others can’t afford high co-pays and drug prices.

“That is disruptive,” said Sanders. “What is not disruptive is expanding Medicare, which is a very popular and cost-effective program to guarantee health care for every man, woman and child.”

The Democratic presidenti­al candidate’s single-payer proposal is coloring the nomination fight and is likely to be a significan­t theme in the 2020 elections. President Trump derides it as “socialism.”

Employers now cover more than 160 million people, roughly half the U.S. population. Medicare covers seniors and disabled people. Medicaid covers low-income people and many nursing home residents.

 ?? Olivier Douliery / Abaca Press ?? Democratic presidenti­al candidate Sen. Bernie Sanders has introduced Medicare for All legislatio­n and defends the plan against a report that says it could disrupt the health system.
Olivier Douliery / Abaca Press Democratic presidenti­al candidate Sen. Bernie Sanders has introduced Medicare for All legislatio­n and defends the plan against a report that says it could disrupt the health system.

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