POLICY BRIEFINGS

Hart Health Strategies provides a comprehensive policy briefing on a weekly basis. This in-depth health policy briefing is sent out at the beginning of each week. The health policy briefing recaps the previous week and previews the week ahead. It alerts clients to upcoming congressional hearings, newly introduced bills, regulatory announcements, and implementation activity related to the Patient Protection and Affordable Care Act (PPACA) and other health laws.


THIS WEEK'S BRIEFING - APRIL 15, 2019

Sanders Reintroduces Medicare for All


Sen. Bernie Sanders (I-Vt.) has introduced an updated version of his “Medicare for All” legislation (S. 1129). Similar to previous iterations of the policy, the bill would replace nearly all forms of private health insurance with a government-managed, single-payer version of Medicare that guarantees coverage to all Americans. The universal health care program would include coverage of primary care, hospital stays, mental health treatment, and prescription drugs. The latest bill would also include coverage for dental, vision, hearing, and home and community-based long-term care services, in line with the House-version of Medicare for All (H.R. 1384) introduced by Rep. Pramila Jayapal (D-Wash.) in February. States would be allowed to provide additional benefits from their own budgets. The Indian Health Service (IHS) and Veterans Health Administration (VHA) would remain in place. The plan would be phased in over four years by gradually lowering the Medicare eligibility age. The House bill would be implemented over only two years. The transition period would phase in benefits while eliminating Part A and B deductibles and waiting periods for Medicare coverage of disabled individuals. It would also provide for continuity of care for people transitioning from private health coverage or from other health care programs such as Medicaid and the Children’s Health Insurance Program (CHIP). When the transition period ends, all individuals would be automatically enrolled in the new system. While the bill does not specify how the health system overhaul would be paid for, Sanders himself has outlined several possible options, including a 4 percent income-based premium on employees and a 7.5 percent income-based premium on employers, eliminating health tax expenditures, imposing a marginal tax rate of up to 70 percent, instituting a higher tax on inheritances, imposing larger fees on financial institutions, or repealing corporate accounting “gimmicks.” Sanders unveiled the Medicare for All bill with the backing of 14 democratic cosponsors. Republicans and the White House have criticized the plan for its lack of any financing mechanisms, raising concerns about the potential adverse impact on access that would result from requiring Americans to switch to a “one-size-fits-all” system.



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