Long-term care added to ‘Medicare for All’
Sen. Bernie Sanders launched a revamped “Medicare for All” plan on Wednesday, highlighting a divide among Democrats over one of their bedrock 2020 campaign issues – the future of health care in America.
As before, the Democratic presidential candidate’s signature proposal would replace job-based and individual private health insurance with a government-run plan that guarantees coverage for all with no premiums, deductibles and only minimal copays for certain services.
In this latest version, Sanders added coverage for long-term care.
Some Democratic 2020 hopefuls point to their support of Medicare for All to prove their progressive bona fides. But other Democrats say it’s not politically or economically feasible because of the large tax increases required, preferring instead to stabilize the Affordable Care Act and use it to expand coverage.
House Speaker Nancy Pelosi has sounded skeptical about Sanders’ plan.
Republicans, meanwhile, cite Medicare for All as Exhibit A in their own 2020 narrative depicting a radicalized Democratic Party steering toward “socialism.”
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.
Sanders and his supporters say it’s a matter of principle.
“Health care is a human right, not a privilege,” declared the Vermont Independent, who is again seeking the Democratic nomination for president, as he unveiled his bill at a Capitol Hill event crowded with nurses and advocates for patients.
Four of Sanders’ fellow senators and rivals for the Democratic nomination have signed onto the updated single-payer health care proposal. In addition to Gillibrand, they are Sens. Cory Booker of New Jersey, Kamala Harris of California and Elizabeth Warren of Massachusetts.
The latest edition of Medicare for All adds coverage for long-term care in home and community settings, on top of its basic promise of comprehensive health coverage, including dental and vison. Brand name prescription drugs would be subject to copays totaling no more than $200 annually.
“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. As with previous versions of the plan, he did not include details on how to pay for it, offering instead some general options.
Capitalizing on Sanders’ unveiling, Sen. John Barrasso, R-Wyo., fired off a letter to the Congressional Budget Office requesting a detailed cost estimate of Medicare for All bills in the House and Senate.
“The American people deserve a complete and thorough vetting of this proposal,” Barrasso wrote to the nonpartisan number crunchers.
Some Democrats seem to be trying to change the conversation inside the party to build consensus around “coverage for all” as distinct from the Sanders plan. They aim to reach that goal through various incremental steps, while preserving the traditional U.S. mix of public and private insurance.
Indeed, a Democratic co-sponsor of an earlier version of Sanders’ bill was among those having second thoughts. Sen. Jeanne Shaheen of New Hampshire did not re-up this time, saying in a statement “there are faster ways to reach universal coverage by building on the progress we’ve made through the Affordable Care Act.”
Democratic presidential candidates who don’t back the Sanders plan are focused on safeguarding popular provisions of the Obama-era ACA, 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.”
Sen. Kirsten Gillibrand, D-N.Y., flanked by Sen. Bernie Sanders, I-Vt., left, and Sen. Jeff Merkley, D-Ore., speaks during a news conference Wednesday on Sanders’ revised “Medicare for All” legislation.