Hearings Begin on “Medicare for All” Legislation

On June 12, 2019, the U.S. House of Representatives’ Ways and Means Committee conducted its initial hearings on H.R. 1384, the Medicare for All Act of 2019. Introduced by U.S. Representative Pramila Jayapal (D-WA) in February, H.R. 1384 would:

  • Provide health coverage for all U.S. residents.
  • Authorize automatic enrollment upon birth or establishment of U.S. residency.
  • Cover 14 service categories, including: hospital services, primary and preventive care, chronic disease management, prescription drugs, mental health and substance abuse treatment, dental and vision care, long-term care services and supports, habilitative services, early and periodic screening for children (EPSDT), and medical transportation.
  • Reimburse institutional providers based on negotiated annual budgets, and pay individual practitioners based on fixed fee schedules.
  • Prohibit cost sharing (deductibles, co-insurance, and copayments).
  • Prohibit balance billing.
  • Allow private health insurers and employers to offer coverage only if it is supplemental to, and not duplicative of, services covered under H.R. 1384.
  • Replace Medicaid, CHIP, TRICARE, the Federal Employees’ Health Benefits Plan, and coverage offered through health insurance Marketplaces.
  • Sunset health insurance Marketplaces and Medicare/Medicaid pay-for-performance programs.
  • Retain veterans’ health programs and the Indian Health Service.

Enrollment would begin two years after the law’s date of enactment—with the exception that children under age 19 and adults over age 55 would have the option to enroll beginning one year after enactment.

Similar Medicare for All legislation, in the form of S. 1129, was introduced in the Senate this year by Bernie Sanders (I-VT).  To date, the Senate has not taken any action on that bill.

Legislators on both sides of the aisle have questioned H.R. 1384 and S. 1129, citing concerns that (if enacted) the laws would increase the Federal deficit, reduce choices for consumers, overturn key provisions of the Affordable Care Act, and take employer-based coverage away from 180 million Americans. These are only two of several related bills that have been introduced in the 116th Congress. Other, similar currently pending proposals include:

  • R. 2452, the Medicare for America Act of 2019, which would create a public program that individuals could opt out of if they have other coverage.
  • Seven other bills that would create a public plan option on the Marketplaces.
  • Two bills that would create a Medicare buy-in option for individuals over age 50.
  • A bill that would create a state option to offer Medicaid buy-in coverage.

For more information about each of these bills, and to compare them side-by-side, visit the Kaiser Family Foundation overview here.

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