Perhaps no issue has divided the field of Democratic 2020 presidential hopefuls more than the debate over “Medicare for All”, Reuters reports.
Progressive candidates favor the sweeping proposal, which would replace private health insurance with a single government-run plan. More moderate candidates have embraced less drastic measures they say would achieve universal healthcare coverage while allowing individuals to choose their plan.
Bernie Sanders, the U.S. senator from Vermont, authored Medicare for All legislation that would essentially abolish private insurance in favor of a single government-run plan that covers every American. The ambitious proposal would cost more than $30 trillion over 10 years, according to independent analyses.
Sanders has acknowledged he would impose higher taxes on families to help pay for the program, but has argued that the typical middle-class family would save overall by eliminating virtually all health expenses.
The bill would transform Medicare – now primarily for Americans aged 65 and over – into a universal system and ban employers from offering healthcare plans to compete with the government. Aside from prescription drugs, patients would face no out-of-pocket costs when accessing medical services.
Several Democratic rivals, including former Vice President Joe Biden, have criticized Sanders’ plan as unrealistic.
Elizabeth Warren, a U.S. senator from Massachusetts, has endorsed Sanders’ proposal. Unlike Sanders, who has not explained specifically how he would pay for the plan, Warren has released a detailed financing proposal.
Warren has estimated Medicare for All would cost $20.5 trillion in additional government spending over 10 years. That is lower than what independent analyses have found, but Warren has argued that she would achieve savings by lowering administrative costs and reducing drug prices, among other changes.
She would rely on tax increases for corporations and the wealthy, most notably billionaires, and said the plan would not raise taxes for middle-class families “one penny”.
The proposal was met with skepticism by several of her Democratic rivals, including Biden, whose campaign accused her of engaging in dishonest “mathematical gymnastics”.
Warren said she would transition to Medicare for All gradually over three years, including initial legislation to make Medicare available to all Americans while preserving existing employer-based insurance at first.
Joe Biden, the No. 2 to former Democratic President Barack Obama has criticized Medicare for All as an effort to dismantle the Affordable Care Act (ACA), Obama’s signature healthcare law.
Instead, Biden has vowed to “build on” the ACA, popularly known as Obamacare, by adding a public option that would leave the current private insurance system in place.
His healthcare plan, estimated to cost $750 billion over 10 years and paid for partly by higher taxes on the wealthy, would let people enroll in a paid government healthcare plan as an alternative to private insurance. The government plan would be modeled on Medicare and available even to workers with employer-provided policies.
The proposal would also expand the ACA’s subsidies for private policies, making them more generous and extending them to more people.
Like Biden, Pete Buttigieg, the mayor of South Bend, Indiana, favors a public option, which would allow individuals to opt into a government plan but would preserve the existing role for private insurers.
Buttigieg, who has coined the phrase “Medicare for all who want it” to describe the concept, has argued that a public option will eventually lead to a single-payer system, because individuals will find that Medicare is more cost-efficient than private policies.
Unlike other fellow senators seeking the Democratic presidential nomination, Amy Klobuchar did not co-sponsor Sanders’ Medicare for All legislation.
Klobuchar, a moderate from Minnesota, has said she would improve on the Affordable Care Act by adding a public option, giving people the chance to choose a government-backed plan. She has criticized Medicare for All as a “pipe dream”.