Democrats of the House will release their bill "Medicare for All" without any price tag • politico.com

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Pramila Jayapal

Representative Pramila Jayapal (D-Wash.), Lead sponsor of the Medicare for All bill, announced that she would publish a separate list of proposed funding mechanisms. | Andrew Harnik / Fantastic Insurance Photo

Health care

A single payer system managed by the government would eliminate most private health insurance and cover abortion.

By and

26/02/2019, 16:31 EST

Update 26/02/2019 19h22 EST

Tue 26 Feb 19:22:20 EST 2019

Progressive Democrats in the House will unveil on Wednesday the all-out Medicare for All bill, which will present the most detailed detailed plan on how they could upset the health system to ensure coverage for every American – a long-sought-after progressive dream that is already shaping the world. Democratic race to challenge President Donald Trump.

The bill, co-sponsored by just over 100 Democrats in the House, does not include specific awards or proposals to fund the new system, which analysts say would cost tens of billions of dollars on a budget. decade. Pramila Jayapal, principal representative of Washington State, announced that she would issue a separate list of suggested funding mechanisms, including a high-income tax and employer-required contributions.

History continues below

The proposal calls for a two-year transformation of Medicare into a universal single-payer system, eliminating almost all private health plans. It would also expand Medicare coverage to include prescription drugs, dental and vision services, and long-term care without charging for a share, premium, or deductible – and would provide federal funding for abortions.

The bill fits into a furious debate within the Democratic Party about the breadth of its health care ambitions, pitting a progressive vocal base keen to make Medicare for All a crucial problem for 2020 against its moderate establishment, more cautious. The question remains open to know where the Democratic leaders will allow the bill to advance in the House as Republicans. claiming hearings on what they make fun of a socialist nightmare.

Advocates of Medicare for All believe that their 100-page bill is a meticulous roadmap for single-payer health care and hope that its unveiling will silence critics who dismissed the idea as a catchy slogan.

"The state of our health care system is absolutely atrocious," Jayapal told reporters on Tuesday. "We think the market is broken, and that's the main idea here: we're trying to fix it."

Republicans, eager for a health insurance showdown for all, argue that this system would cost taxpayers tens of billions of dollars and would force hundreds of millions of patients from their private plans to managed coverage by the government. Powerful health groups who joined the Democrats to help pass Obamacare nearly a decade ago have also unified to fight against a concept that would reorganize the health system and threaten their business models. .

Nevertheless, several Democratic presidential candidates have adopted Medicare for All as a political rallying cry over the past year, as polls show that the public is increasingly in favor of universal health coverage and left wider among Democratic voters. However, aside from Senator Bernie Sanders (I-Vt.), Who introduced the liberal fringe idea into the mainstream during his 2016 presidential campaign, most candidates avoided offering details that would to provoke criticism.

Recent surveys have revealed that the public sees the concept of a single payer system favorably. But this support erodes dramatically when voters learn that it would eliminate most private health insurance and could raise taxes. Republican lawmakers are convinced that the policy will hurt Democrats in the 2020 elections, especially among moderate suburban voters who helped the party resume its role in the House of Representatives in November.

Asked about the unique pressure prospects of Progressive Progressive Democrats on Tuesday night, Rep. Andy Harris (R) just laughed. "I'm not worried about it," said Harris, a doctor.

But progressive lawmakers, led by Jayapal and Sanders, are also confident that the public will adopt a single-payer plan if Democrats show enough vigor. They plan to pressure their fellow Democrats and contenders to 2020 to fully embrace the overhaul of the health care system that they say has left the American people behind.

"I think this Health Insurance for All bill clearly states what we mean by Medicare for All: we mean a complete transformation of our health care system," Jayapal said. "Nibbled on the edges."

Two House committees will hold the first health insurance hearings for everyone next month, but the leaders made no other commitment to move the bill forward.

The House bill largely reflects Sanders' Medicare for All bill in the Senate. Both bills argue widely for the feasibility of a costly transition that would reshape the Medicare program and make it a universal insurer.

Greg Walden and Kevin Brady "data-size =" promo_xsmall_rectangle

But unlike the Sanders Plan, Jayapal's bill would allow the government to fund long-term care, a particularly expensive part of the health care system. The bill also provides for a two-year transition to a single payer, which is faster than Sanders' four-year bill.

In addition, the inclusion of an abortion coverage would eliminate the long-standing prohibition of federal dollars for the procedure in almost all cases. States would also be prohibited from excluding abortion providers such as Planned Parenthood, which some Red States have attempted to hunt for Medicaid.

Under the bill, a new government-funded coverage would become available at the end of the first year of transition for a large portion of the population: those currently enrolled in Medicare, people over 55 and under 19 years old. the program this first year, then the system would come into effect for everyone by the end of the second year. There are some exceptions for those covered by Veterans Affairs and the Indian Health Service. Jayapal confirmed Tuesday that the plan would allow the Secretary of Health and Social Services to extend public health coverage to undocumented immigrants.

The bill does not include cost estimates and funding, but House progressives are trying to take into account the funding of such a review. During a phone conversation with reporters, Jayapal proposed several solutions to cover program costs, including a "wealth tax" on millionaires and billionaires, as well as reductions in tax cuts from GOP and employer contributions.

The bill also orders the creation of a national health budget requiring federal officials to negotiate annual payments to providers in advance. And, during the first five years, at least 1% of this huge budget would go to programs helping millions of displaced health workers through the creation of a single, government-run system, including the "replacement of "salary" and pension benefits. training. Jayapal estimated that between 1 and 2 million people in the private health insurance sector could lose jobs.

The government would also be able to negotiate drug prices directly with pharmaceutical companies – a long-standing political priority for Democrats – and create a single list of covered drugs that encourages providers to use cheaper generics.

Advocates of Medicare for All have long argued that Americans would ultimately pay less with a single payer system, even with tax hikes, as they would no longer need to shell out premiums and pay the premium. -part, nor to be faced with thousands of dollars in unexpected medical expenses. expenses. According to the Journal of the American Medical Association, Americans pay almost twice as much for per capita health care as citizens of other industrialized countries and have worse health outcomes.

"I actually think the issue is not about how we pay for it," said Jayapal, noting that hundreds of billions of dollars are routed each year to the federal defense budget with little objection. "It's a question of political will."

But skeptics dismissed the idea that Medicare for All would allow Americans to save money, largely because single payer proposals have not yet spelled out the money. The scale of the tax increases and the economic changes needed – a lot of these would hit the middle class and risk being put aside. health insurance support for all.

It is unclear when and if the Congressional Budget Office will evaluate the bill and allocate a price. During a phone conversation with reporters, a Jayapal staffer preemptively dismissed the Congress Keeper's ability to evaluate this bill, echoing House Republicans' complaints about Office projections that their repeal legislation of Obamacare would cost health coverage to millions of people. Jayapal said the bill was intended primarily to draw attention to the flaws in the current health care system and help defend the single payor case.

Nancy Pelosi "data-size =" promo_xsmall_rectangle

Among the first co-sponsors of the bill is a group of progressive democrats, ranging from prominent high-profile students such as Alexandria Ocasio-Cortez (DN.Y.) to important liberal pillars such as Raul Grijalva's representatives (D -Ariz.) And Jim McGovern (D-Mass.), Chairman of the House Rules Committee. Massachusetts Representative Katherine Clark, Democrat in House No. 6 and the second highest-ranked woman in the caucus, also signed.

Initially, the bill had fewer co-sponsors than the 124 Democrats who had adhered to a previous version of the Medicare for All bill last year, while the old bill did not have the same number of sponsors. was a general overview that the former representative, John Conyers (D-Mich.), had presented on several occasions. several years before his resignation in late 2017. Jayapal took over the law last year and has rewritten and developed it for months.

While the House and Budget Committees are scheduled to hold Medicare for All hearings starting in March, the bill did not spark firm commitments from the Energy and Trade Working Groups. and Ways and Means, which amendments are necessary for the bill to be presented to the House.

The Democratic establishment, anxious not to vote on a divisive policy that has no chance of becoming law under President Donald Trump, is pushing the caucus to focus on strengthening the government. Obamacare and the protection of the protections of the law for pre-existing conditions. helped the Democrats regain the House in November. Some also have ideas for expanding government coverage to small groups, like near-retirees, without overhauling the entire health system.

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