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 The bill, unveiled by Democratic Representative Pramila Jayapal from
Washington state, would transition the U.S. healthcare system to a
single-payer "Medicare for All" program funded by the government in
two years. The legislation is the party's most high-profile and
ambitious single-payer proposal in the new Congress and has more
than 100 co-sponsors, many from the party's progressive flank.
It is unlikely to gain the support of any Republicans in the House
or the Senate, who have derided single-payer healthcare as a
socialist policy and oppose government interference in healthcare.
It also remains unclear whether Democratic House Speaker Nancy
Pelosi will bring the legislation up for a vote.
"Americans are literally dying because they can't afford insulin or
they can't get the cancer treatment they need," Jayapal said on a
call with reporters on Tuesday. "There are some things that should
not be provided through the for-profit market."
Medicare currently serves about 60 million Americans who are age 65
or older, or disabled. Jayapal's legislation would eliminate the age
threshold. The new Medicare would not require any beneficiaries to
pay premiums or deductibles and would not charge patients co-pays or
out-of-pocket costs after receiving care.
It does not include new or increased taxes or other additional
revenues to pay for the healthcare overhaul. Jayapal said possible
ways to pay for the bill include a tax on millionaires and
billionaires, employer premiums and closing tax loopholes for the
wealthy.
The idea of Medicare for All was first proposed by Independent
Bernie Sanders in 2017 as a single-payer system that would largely
replace private insurance. It gained traction among Democrats
running for congressional office in 2018, and is now a central
campaign issue for party members vying for the 2020 presidential
nomination.
A Reuters/IPSOS poll in August found that 70 percent of Americans
support some sort of single-payer system.
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The health industry has opposed single-payer proposals, saying they
would ultimately lead to less access to care. Critics include the
American Hospital Association and America's Health Insurance Plans (AHIP),
the health insurance industry's biggest trade group.
"This bill will hurt patients, consumers, and taxpayers: Americans
will pay more, to wait longer, for worse care," AHIP said in a
statement. "Let’s focus on real solutions that deliver real results,
not a one-size-fits-all government system."
The House proposal unveiled on Tuesday would not eliminate private
health insurance entirely, as it would allow patients to purchase
supplemental coverage. Many Americans under the age of 65 rely on
private insurance provided by their employer.
A single-payer system is variously understood as one in which the
government pays for healthcare for more people, or one where the
governments owns health services providers and manages all aspects
of care, such as in the United Kingdom.
Several U.S. Democratic lawmakers have introduced different versions
of expanded Medicare, such as allowing people aged 50 and older to
buy into the program.
The new House proposal would cover most aspects of patients' care,
including primary care, hospital and outpatient services,
prescription drugs, dental, vision, audiology, women's reproductive
health services, maternity and newborn care.
(Reporting by Yasmeen Abutaleb; Additional reporting by Amanda
Becker and Susan Cornwell in Washington; Editing by Lisa Shumaker)
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