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Democrats are about to drop their most aggressive "Medicare for All" bill yet. Here's what's in it.

This time around, more people will be covered sooner.

by Rex Santus
Feb 26 2019, 10:47pm

House Democrats will unveil new “Medicare for All” legislation on Wednesday — just as contenders for their party’s 2020 presidential nomination argue over the fine print of what that program would actually entail.

It’s the most aggressive form of the legislation yet, which Democrats have filed many times in the past. This time around, more people will be covered sooner, and the bill’s text is much longer and more detailed than before.

If passed, the legislation would practically eliminate the private insurance industry by prohibiting the sale of health insurance coverage that duplicates the benefits available under Medicare for All, which would cover a wide variety of services traditionally covered by private health insurance. Rep. Pramila Jayapal, a prominent Democrat from Washington who co-chairs the Congressional Progressive Caucus, is sponsoring the bill, along with Reps. Debbie Dingell of Michigan, Jim Langevin of Rhode Island, and more than 100 other co-sponsors. A Senate version of the new bill will be introduced in the coming weeks.

“The state of our healthcare system is absolutely atrocious,” Rep. Jayapal told reporters Tuesday. “In America, we have 30 million people who are uninsured. We have at least 40 million people who are underinsured.”

“Americans are literally dying because they can’t afford insulin or get the cancer treatments they need,” she added.

The benefits covered by the bill are sweeping:

  • Hospital services, including inpatient and outpatient hospital care, 24-hour-a-day emergency services, and inpatient prescription drugs
  • Ambulatory patient services
  • Primary and preventive services, including chronic disease management
  • Prescription drugs, medical devices, and biological products, like vaccines and blood agents
  • Mental health and substance abuse treatment services, including inpatient care
  • Laboratory and diagnostic services
  • Comprehensive reproductive, maternity, and newborn care
  • Pediatrics
  • Dental, audiology, and vision services
  • Rehabilitative services and devices
  • Dietary and nutritional therapies
  • Podiatric care
  • Emergency services and transportation
  • Early and periodic screening, diagnostic, and treatment services
  • Transportation to receive health care services for persons with disabilities or low-income individuals
  • Long-term care services and supports

The legislation also plans to eliminate premiums and deductibles, and recipients would not be charged co-pays or any other out-of-pocket costs. Patients could also visit any hospital or doctor they want without worrying about if their insurance is in-network.

And everyone would have full abortion coverage by disallowing the Hyde Amendment, which blocks nearly all Medicaid funding for abortion coverage.

The transition would occur over two years, and Jayapal rattled off a “short list” of ideas for how to pay for Medicare for All, including a tax on millionaires and billionaires, a premium for employers, corporate taxes, and the undoing of President Donald Trump’s tax cuts that principally benefit the wealthy.

One year after the Medicare for All passes, people over 55 and people under 19 would be eligible. After two years, coverage expands to everyone.

Jayapal said the bill would deliver a huge blow to private insurance companies, which she said had no role in providing core health insurance to everyday Americans.

“There are some things that should not be provided through the for-profit marketplace, and we believe healthcare should be one of them,” Jayapal said.

The question over private insurance’s role in Medicare for All, a concept that enjoys broad support from presidential contenders, has become a splitting point for 2020 Democrats. Candidates Bernie Sanders, Kamala Harris, Kirsten Gillibrand, Cory Booker, and Elizabeth Warren have already co-sponsored a Senate bill that seeks to mostly oust private insurers, though Booker flopped on the issue by saying private insurance should still exist.

Warren has also distanced herself from the Senate bill and said that there are numerous ways to get to universal healthcare. The debate splinters even further, with centrist Democrats like Sherrod Brown and Amy Klobuchar supporting “Medicare for More,” which expands coverage to people as young as 50 but not to everyone.

While Trump is president, the bill has no chance of becoming a reality, but Jayapal noted that this bill has more than double the original co-sponsors of similar legislation introduced in past Congresses, a clear indication of a shift in Medicare for All favorability.

Cover image: Rep. Pramila Jayapal, D-Wash, speaks at a news conference on Capitol Hill in Washington, Wednesday, Jan. 30, 2019. (AP Photo/Andrew Harnik)