Tag Archives: Government-funded health insurance

Biden made ‘Obamacare’ cheaper, now sign-up deadline is right here


Midnight on Sunday is the deadline for shoppers to benefit from a particular “Obamacare” join interval, courtesy of President Joe Biden

“We have seen even within the final couple of weeks elevated curiosity in enrollment,” Administrator Chiquita Brooks-LaSure stated in an interview. “If you make protection extra reasonably priced, folks purchase it. What we have to do is to make protection extra reasonably priced.”

Biden’s particular enrollment interval ends at midnight native time Sunday across the nation. The common annual sign-up season will not begin once more till Nov. 1.

Curiosity has been excessive in a few states feeling the scourge of the delta variant. Almost 490,000 folks have signed up in Florida, and greater than 360,000 have accomplished so in Texas.

At a nonprofit service middle in Austin, Texas, greater than 500 folks have enrolled thus far with the assistance of employees and volunteers. Basis Communities well being program director Aaron DeLaO stated the schedule is booked and so they’re working to clear the ready record.

“Particularly with the delta variant, persons are fascinated about their well being a bit extra,” he stated.

The appliance course of will be difficult, requiring particulars about citizenship or authorized immigrant standing, revenue, and family members. That is earlier than a client even picks a medical health insurance plan. Individuals can apply on-line, by way of the HealthCare.gov name middle, or by packages just like the one in Austin.

About 9 in 10 prospects at Basis Communities have chosen commonplace “silver” plans, which value considerably extra however provide higher monetary safety when sickness strikes. “That to me says that persons are actually all for having complete protection,” stated DeLaO.

The Obama-era Reasonably priced Care Act presents sponsored non-public insurance coverage to individuals who haven’t got job-based protection, out there in each state. The ACA additionally expanded Medicaid for low-income adults, an choice most states have taken. The 2 elements cowl about 27 million folks, in accordance with the nonpartisan Kaiser Household Basis.

“Obamacare’s” place amongst authorities well being packages appears safe now, after greater than a decade of fruitless efforts by Republicans to repeal it or get the Supreme Court docket to overturn it. Earlier this 12 months by a vote of 7-2 the conservative-leaning court docket dismissed the most recent problem.

The subsidy will increase in Biden’s COVID legislation have made a tangible distinction. The typical premium paid by new prospects dropped from $117 a month to $85 a month, or 27%, with the extra beneficiant assist. In line with CMS, the median — or midpoint — deductible went from $450 to $50, a discount of practically 90%. Individuals who already had ACA protection may get the elevated assist by going again to the insurance coverage market. Individuals who’ve had a spell of unemployment are eligible for added breaks.

However the enhanced subsidies are good solely by 2022, and Biden is urgent Congress to make them everlasting. An extension appears more likely to be included within the Democrats’ $3.5 trillion home coverage bundle, nonetheless it is not assured to be everlasting, with so many different priorities competing for cash.

About 30 million folks stay uninsured, and a transparent majority could be eligible for ACA plans or another kind of protection. “In the event you construct it they will not essentially come,” stated Karen Pollitz, a medical health insurance skilled with the Kaiser Basis. “Individuals nonetheless have to be made conscious that there’s protection on the market.”

The Biden administration might make progress, however “this cannot be the top of the story,” stated well being economist Katherine Baicker of the College of Chicago.

It stays means too difficult for individuals who juggle low-paying jobs to get and maintain protection, Baicker defined. “There’s each a have to broaden entry to reasonably priced insurance coverage and to raised inform folks concerning the choices out there to them,” she stated.


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Trump cites his help for Medicare, slams Medicare for All


President Donald Trump on Thursday accused Democrats of an all-out try and “completely obliterate Medicare” and portrayed himself as this system’s defender as he signed a directive to develop this system’s personal insurance coverage choices.

Trump skipped previous his personal proposals for Medicare price range cuts, and he ignored the truth that no Democrat is proposing to take protection or advantages away from seniors.

Throughout a go to to The Villages, a bustling neighborhood for adults in Central Florida, Trump was attempting to show consideration away from Home Democrats’ impeachment inquiry and concentrate on pocket-book points as an alternative.

“That’s why they do the impeachment crap, as a result of they know they will’t beat us pretty,” he advised the pleasant viewers, which included many seniors. That a part of Florida voted overwhelmingly for Trump in 2016.

Well being care has emerged as a central difficulty for Democrats competing for his or her celebration’s 2020 presidential nomination. A lot of the talk has centered on Sen. Bernie Sanders’ “Medicare for All” plan, which might cowl everybody beneath a government-run plan and remove most personal insurance coverage. Trump stated electing a Democrat would jeopardize seniors’ entry to well being care.

“Medicare is beneath risk like by no means earlier than,” Trump stated. “Virtually each main Democrat in Washington has backed a large authorities well being care takeover that may completely obliterate Medicare.”

Removed from “obliterating’’ Medicare, Sanders says his plan would decrease prices and supply new advantages, together with protection for long-term care. Medicare, which covers about 60 million seniors and disabled individuals, is the federal government’s flagship well being care program.

Trump additionally signed an government order directing his administration to pursue modifications to Medicare. A lot of what he needs to do is geared towards enhancing Medicare Benefit, the personal insurance coverage choice picked by about one-third of seniors.

Medicare Benefit plans provide financial savings on premiums and an annual restrict on out-of-pocket prices. These plans present one-stop purchasing, eliminating the necessity for separate supplemental insurance coverage. Provided by main insurers, the plans additionally cowl prescribed drugs typically.

However there are trade-offs. Folks becoming a member of a Medicare Benefit plan typically should settle for limits on their alternative of hospitals and medical doctors in addition to prior insurer approval for sure procedures. If they modify their minds and determine to return to conventional Medicare, they’re not all the time assured supplemental “Medigap” protection, which can be personal.

The president’s order is mainly a to-do listing for the Division of Well being and Human Providers that can require months of follow-up. Among the many different priorities are an growth of telemedicine and modifications to keep away from overpaying for procedures simply because they get accomplished in a hospital as an alternative of a physician’s workplace.

Well being and Human Providers Secretary Alex Azar stated Trump’s order directs his division to look at whether or not its present insurance policies and practices put conventional Medicare forward of the personal Medicare Benefit choice. Some advocates for older individuals say that it’s the opposite means round and that the administration is attempting to place personal plans forward.

The manager order doesn’t contain a significant overhaul of Medicare, which might require congressional approval.

Thus far the talk about Medicare for All has primarily been about its projected prices to the federal government, estimated at $30 trillion to $40 trillion over 10 years.

The Sanders plan would remove most personal medical health insurance, together with the Medicare Benefit choice. Sanders, who unexpectedly underwent a coronary heart process this week, says Medicare for All would nonetheless provide seniors broader advantages and decrease prices.

Sanders’ type of single-payer well being care has lengthy been common amongst liberals. However current polling has proven {that a} majority of Democrats and independents who lean Democratic choose increasing protection by constructing on the Inexpensive Care Act, or the Obama-era well being regulation. Trump is asking federal courts to overturn that regulation as unconstitutional.

As a presidential candidate, Trump promised to not minimize Medicare. As president, he has prevented calling for privatization of this system, elevating the eligibility age past 65 or rolling again advantages.

However Trump’s newest price range proposed steep cuts in Medicare funds to hospitals and different service suppliers, prompting protests from the business and accusations by Democrats that he was going again on his guarantees to seniors. The Medicare cuts went nowhere in Congress.


Alonso-Zaldivar reported from Washington. Related Press author Deb Riechmann in Washington contributed to this report.


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Warren has personal plan for every part, although not well being care


Elizabeth Warren has a plan for that. However on well being care, she’s with Bernie.

Warren, a Massachusetts senator and a number one liberal Democratic presidential candidate, has stood out within the 2020 race for her extraordinary give attention to detailed plans to deal with the nation’s most urgent points. Her web site lists particular insurance policies for 43 matters, from gun violence and Social Safety to the Electoral School and household farmers.

However on well being care, a problem that issues probably the most to many citizens, Warren is all in on her opponent Bernie Sanders’ “Medicare for All” plan.

The seeming inconsistency was highlighted throughout this previous week’s presidential debate by Democratic front-runner Joe Biden as he defended his personal plan to develop the well being care overhaul put in place whereas Barack Obama was president.

“The senator says she’s for Bernie,” Biden quipped. “Nicely, I am for Barack.”

No subject has outlined the early months of the nomination struggle greater than well being care, which has emerged as a robust proxy within the broader struggle for the celebration’s soul within the age of Trump.

The difficulty is a fragile one for Warren. She must unify the progressive wing behind her candidacy to overhaul Biden within the major, if she is to emerge because the nominee towards President Donald Trump within the basic election.

Medicare for All is Sanders’ signature subject, and as such, she will sick afford any daylight on well being care between her and Sanders, a self-described democratic socialist, if she finally hopes to win over his supporters.

On such a important subject, Warren allies imagine there isn’t any incentive to complicate the talk with a brand new plan.

“Making clear that they are aligned on the North Star aim of Medicare for All is a crucial long-term funding in her relationship with Sanders’ voters — in addition to an vital short-term funding in readability for all voters,” stated Adam Inexperienced, co-founder of the Progressive Change Marketing campaign Committee and a vocal Warren supporter.

Certainly, the interior battle over well being care has two very clear factions.

Biden leads those that desire to depart the personal insurance coverage market in place however give individuals the selection to hitch a government-backed “public choice.” Sanders leads the strategy, which might substitute the personal insurance coverage market altogether with a single-payer well being care system requiring just about no out-of-pocket prices.

From the start, Warren has been clearly aligned with Sanders’ faction. But a few of Sanders’ supporters will not be but satisfied that she’s as dedicated to Medicare for All because the plan’s creator. Progressive critics famous, for instance, that Warren indicated she supported “quite a lot of plans” when requested about well being care in an interview after the talk.

“I assist Medicare for All. I believe it is a good plan. And look, I assist quite a lot of plans — different issues that folks have give you. Once they’re good plans, let’s do it,” Warren informed CBS. “This is not some form of contest (the place) I acquired to think about mine first. It is what’s greatest for the American individuals.”

A spokeswoman later clarified that Warren doesn’t assist any plans on well being care and that the senator’s reference to supporting “quite a lot of plans” utilized solely to different insurance policies.

Nina Turner, who co-chairs Sanders’ marketing campaign, applauded Warren’s constant public embrace of Medicare for All.

“For Sen. Sanders, it is a fantastic factor to have a fellow progressive comply with his lead on the signature subject of his marketing campaign,” Turner stated.

However she prompt that solely Sanders is invested sufficient within the plan to make sure it finally turns into legislation.

“He is the one one who will see it by all the best way to the tip,” she stated. “That is in his bones.”

Katherine Brezler, who co-founded the group Individuals for Bernie Sanders, stated Warren’s embrace of Sanders’ well being plan has helped preserve good relations between the 2 rivals and their supporters.

“I genuinely suppose that neither camp is actually going to have that onerous a time voting for the opposite,” stated Brezler, who helped increase cash for Warren’s first Senate bid.

Warren’s marketing campaign declined to remark for this story other than pointing to the CBS interview.

Throughout the debate, she repeatedly defended her assist for the plan, however she let Sanders punch again at Biden when the previous vp raised questions on its value.

Biden famous Medicare for All would value taxpayers roughly $30 trillion. A fiery Sanders stated the present system would value $50 trillion whereas leaving greater than 80 million American uninsured or underinsured.

Medicare for All, Sanders stated, would cowl everybody and get rid of all out-of-pocket bills, deductibles and co-payments.

“I … wrote the rattling invoice, if I could say so,” Sanders stated as Warren regarded on.


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Medicare to cowl breakthrough gene remedy for some cancers


Increasing entry to a promising however pricey therapy, Medicare mentioned Wednesday it is going to cowl for some blood cancers a breakthrough gene remedy that revs up a affected person’s personal immune cells to destroy malignancies.

Officers mentioned Medicare will cowl CAR-T cell therapies for sure kinds of lymphoma and leukemia , makes use of which might be permitted by the Meals and Drug Administration. The associated fee can run to a whole lot of hundreds of {dollars} per affected person, not counting hospitalization and different bills.

Medicare Administrator Seema Verma mentioned the choice will present constant and predictable entry nationwide, opening up therapy choices for some sufferers “who had nowhere else to show.”

CAR-T makes use of gene remedy strategies to turbocharge the affected person’s personal immune system cells, reprogramming them to harbor a “receptor” that zeroes in on most cancers, after which to develop a whole lot of thousands and thousands of copies. The revved-up immune cells are returned to the affected person’s bloodstream and may proceed to struggle most cancers for months or years.

Though negative effects will be extreme, research have proven the therapy to be extremely efficient in opposition to sure kinds of cancers. Researchers are working so as to add extra varieties to that record.

Medicare has been weighing the choice for months. This system usually units the tone for personal insurance coverage as properly.

In its announcement, Medicare mentioned it is going to cowl CAR-T when the therapy is offered in establishments which might be enrolled with the FDA in a particular program to advertise security. It should additionally cowl the therapy for different makes use of, if they’re really useful by agency-approved medical analysis literature.

CAR-T makes use of a distinct technique than different gene-therapy strategies. As an alternative of attempting to repair disease-causing genes, it focuses on the affected person’s immune system, particularly the T cells that battle overseas substances within the physique. The issue with most cancers is that malignant cells can usually evade detection by the affected person’s T cells. CAR-T helps the physique’s personal T cells do a greater job of recognizing tumors.

Medicare covers greater than 60 million seniors and other people with disabilities.


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Examine: Dwelling-delivered meals may lower your expenses for Medicare


Medicare may save $1.57 for each greenback spent delivering free well beingy meals to frail seniors after a hospitalization, based on a brand new research that comes as lawmakers look to restrain prices by selling sufferers’ well-being.

The report Thursday from the Bipartisan Coverage Middle addresses ways in which Medicare can do a greater job coordinating take care of chronically sick sufferers, who account for many of the program’s $650 billion annual value. There is a rising recognition that sensible providers like meal supply could make a distinction serving to older folks keep away from well being flare-ups that may ship them to the hospital .

“If you happen to have been going to supply meals to each Medicare beneficiary, it might be cost-prohibitive,” stated Katherine Hayes, well being coverage director for the middle. “By concentrating on it to a really, very sick group of individuals is how we have been capable of present there may very well be financial savings.”

Sen. Ron Wyden of Oregon, the rating Democrat on the committee that oversees Medicare, stated lawmakers acknowledge the worth of offering extra assist providers for sufferers and he’d be all in favour of increasing such advantages for seniors in conventional Medicare.

The Bipartisan Coverage Middle requested well being coverage advisor Ananya Well being Improvements to research the potential impression of a narrowly tailor-made meal profit for Medicare.

Utilizing 2016 billing knowledge that mirrored precise circumstances, the advisor centered on sufferers with power circumstances similar to diabetes, coronary heart failure, Alzheimer’s and osteoporosis. Sufferers needed to have two or extra such circumstances, together with limitations doing day by day duties similar to bathing, cooking or getting dressed. Most have been 75 or older. Some have been dwelling alone.

The research discovered greater than 575,000 sufferers with about 1 million hospital stays. Utilizing different established analysis as a information, the advisor estimated that offering seven days of wholesome meals may keep away from practically 10,000 return journeys to the hospital leading to admission.

Medicare would have needed to spend about $101 million a 12 months to supply meals, however it might have averted greater than $158 million in payments from return journeys to the hospital. The online financial savings can be about $57 million.

In a real-world scenario, the financial savings may very well be higher as a result of the research didn’t bear in mind emergency room visits and nursing house admissions that might probably be averted.

Many households have had the welcome expertise of neighbors and mates dropping off home-cooked meals throughout a well being disaster. For Medicare sufferers, who could be remoted from household and mates, meals can present well being advantages as properly. For instance, wholesome meals might help an individual with diabetes keep away from too-high or too-low blood sugars. Or a affected person with coronary heart failure can keep away from snacking on salty junk meals which will result in fluid increase within the physique.

“There’s a rising physique of proof that means that home-delivered meals can play a job in stopping undesirable emergency room visits and hospitalizations,” stated Tricia Neuman, a Medicare skilled with the Kaiser Household Basis. “Individuals who ship meals can test to make certain sufferers are comparatively secure, taking their drugs, and … have acceptable diet to assist their restoration.”

Medicare Benefit plans bought by personal insurers underneath Medicare’s umbrella have already began providing such “supplemental” assist providers to sufferers who qualify. Along with meals, they’ll embody minor house enhancements like seize bars within the bathe, or respite care. The personal plans have leeway to tailor a few of their advantages. However it’s not occurring but for the two out of three beneficiaries lined by the standard program.

The Bipartisan Coverage Middle is recommending that lawmakers grant Medicare particular authority to supply advantages similar to home-delivered meals, however solely underneath sure circumstances, together with a willpower by company consultants that it might not improve general spending.



Bipartisan Coverage Middle report – https://bipartisanpolicy.org/report/next-steps-in-chronic-care/


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Senators unveil compromise to reduce drug costs for seniors


Two senior senators — a Republican and a Democrat — unveiled compromise legislation Tuesday to reduce prescription drug costs for millions of Medicare recipients, while saving money for federal and state health care programs that serve seniors and low-income people.

Iowa Republican Charles Grassley and Oregon Democrat Ron Wyden said the bill would for the first time limit drug copays for people with Medicare’s “Part D” prescription plan , by capping patients’ out-of-pocket costs at $3,100 a year starting in 2022. They’re hoping to soon have it ready for votes on the Senate floor.

The bill would also require drugmakers to pay a price hike penalty to Medicare if the cost of their medications goes up faster than inflation. Drugs purchased through a pharmacy as well as those administered in doctors’ offices would be covered by the new inflation rebates.

The senators said preliminary estimates from the Congressional Budget Office show that the Medicare program would save $85 billion over 10 years, while seniors would save $27 billion in out-of-pocket costs over the same period, and $5 billion from slightly lower premiums. The government would save $15 billion from projected Medicaid costs.

CBO also projected that Medicare’s inflation rebate would have ripple effects, leading to prescription drug savings for private insurance plans sponsored by employers or purchased directly by consumers.

The senators announced a Thursday vote on the package by the Finance Committee, which oversees Medicare and Medicaid. Grassley is the panel’s chairman, while Wyden serves as the senior Democrat.

“Pharmaceutical companies play a vital role in creating new and innovative medicines that save and improve the quality of millions of American lives, but that doesn’t help Americans who can’t afford them,” Grassley and Wyden said in a joint statement. “This legislation shows that no industry is above accountability.”

The White House encouraged the Senate negotiations, but Democrats controlling the House want to go farther by granting Medicare legal authority to directly negotiate prices with pharmaceutical companies. Direct negotiations are seen as a nonstarter in the Republican-controlled Senate, but the bill’s drug price inflation penalty may yet find support among Democrats in the House.

There was no immediate reaction from the White House.

Grassley’s office said the bill will force drugmakers and insurers to take greater responsibility for keeping Medicare prescription prices in line, instead of foisting increases on taxpayers and beneficiaries.

The lack of a cap on out-of-pocket costs for Medicare’s popular prescription benefit has left some beneficiaries with bills rivaling a mortgage payment. That’s because with Medicare’s current protection for catastrophic costs, patients taking very expensive drugs are still responsible for 5% of the cost, with no dollar limit on what they pay. For example, 5% of a drug that costs $200,000 a year works out to $10,000.

The Grassley-Wyden bill does not directly address the problem of high launch prices for new medications, but its inflation rebates could put the brakes on price hikes for mainstay drugs such as insulin. Nonetheless, the proposed changes are likely to encounter stiff resistance from the drug industry as well as pushback from insurers.

Other provisions of the legislation would:

— Change an arcane Medicaid payment formula through which drugmakers can avoid paying rebates on certain drugs, depending on fluctuations in prices.

— Allow state Medicaid programs to pay for expensive gene therapy treatments on the installment plan, spreading out the costs over several years.

— Require drugmakers to provide public justification for new high cost drugs or steep hikes in the prices of existing medications.

— Require middlemen known as pharmacy benefit managers to disclose details of the discounts they are negotiating and how much they are passing on to consumers. The benefit managers negotiate with pharmaceutical companies on behalf of insurers and consumers.

— Provide doctors with new computer tools they can use to estimate out-of-pocket medication costs for patients with Medicare.


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California sues US over home health worker union dues


Five states have joined forces to try and block a new rule from the Trump administration they say weakens labor unions and their ability to collectively bargain for wages and benefits.

California Attorney General Xavier Becerra, a Democrat, announced the lawsuit on Monday with attorneys general in Washington, Connecticut, Massachusetts and Oregon.

The lawsuit seeks to block a rule finalized last week by the Centers for Medicaid & Medicare Services. Becerra and union leaders say it would ban home health care workers paid for by Medicaid from automatically deducting their union dues and health insurance premiums from their paychecks.

CMS spokesman Jack Cheevers declined to comment on Monday, saying the agency has not seen the lawsuit yet. But in announcing the final rule last week, CMS said “nothing in this rule would interfere with an employer’s ability to make payroll deductions that are required by law or voluntary deductions for things like health and life insurance … and union dues.”

In 2014, the U.S. Supreme Court ruled union dues for home health care workers had to be voluntary, meaning unions could not deduct dues from employees who were not members yet were still covered under the collective bargaining agreement. That same year, former President Barack Obama’s administration issued a ruling clarifying states could deduct dues from paychecks of home health care workers who volunteered to join the union.

The Trump administration reversed that rule, arguing it violated federal law that bans states from diverting Medicaid money to third parties, with some exceptions. But Becerra and union leaders said it is designed to weaken the finances of unions by making it harder for people to pay their dues.

“It is a shameful political attack on home care providers who are largely women and people of color,” said April Verette, president of SEIU Local 2015, which represents more than 385,000 long term care workers in California.

Home health care workers are part of Medicaid’s In-Home Supportive Services program. California has the largest IHSS program in the country, with more than 500,000 patients and more than 470,000 workers.

Becerra noted California and other states could get around this new rule by declining to accept Medicaid dollars for the In-Home Supportive Services program. But Becerra noted for California that would mean forfeiting $6.5 billion in federal tax dollars. California has the largest IHSS program in the country, with more than 500,000 patients and more than 470,000 workers.

“That is not an option in California,” Becerra said. “We have a responsibility to these workers and to the people they care for to fight back when their rights and their health care are at stake.”


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Bernie Sanders relaunches ‘Medicare for All’ amid 2020 glare


Sen. Bernie Sanders of Vermont will unveil a new version of his “Medicare for All” plan on Wednesday, shaking up the 2020 presidential election by reopening the debate over his call to eliminate private health insurance.

Four of Sanders’ fellow senators and rivals for the Democratic nomination are set to sign onto the updated single-payer health care proposal. The bill’s reintroduction promises to shine a bright light on Democratic presidential candidates’ disparate visions for the long-term future of American health care.

Under fire from President Donald Trump and Republicans for the astronomical price tag of Medicare for All, some candidates who support the plan tout it as one of several ways to achieve more affordable coverage and lower the number of uninsured. And others who don’t back it are instead focusing on safeguarding popular provisions of the Affordable Care Act, such as the one that protects coverage of pre-existing conditions.

“Of course, our No. 1 goal should be to make sure we keep in place those protections so people don’t get kicked off their insurance,” Sen. Amy Klobuchar , a Minnesota Democrat who isn’t signed onto Sanders’ bill, told reporters Tuesday. “Then we also have to see the Affordable Care Act as a beginning and not an end.”

Klobuchar supports a so-called public option, versions of which would allow Americans to buy into Medicare or Medicaid. Four other Democratic senators also running for president — Elizabeth Warren , Cory Booker , Kamala Harris and Kirsten Gillibrand — back Sanders’ single-payer plan, which would replace the current mix of private and government health insurance in the U.S. with a new system run by the government. But they have also signed onto at least one version of a public option.

Warren pointed to “a lot of different pathways” to universal coverage during a televised CNN town hall last month. “What we’re all looking for is the lowest cost way to make sure that everybody gets covered.”

The debate is unfolding in the early stages of a Democratic primary in which some candidates have pointed to their support of Medicare for All to prove their progressive bona fides. But other Democratic contenders, including former Colorado Gov. John Hickenlooper , have criticized Sanders’ measure as politically infeasible.

Under Medicare for All, Americans would no longer pay premiums or face insurance deductibles as the government-run system replaced private health insurance offered through employers, the mainstay of coverage for more than 160 million Americans.

Big tax increases would be needed to finance such a system. The transition is likely to be complicated, dismantling the private health insurance industry and making major changes for hospitals, doctors, drug companies and other medical providers.

“What our system does is get rid of insurance companies and drug companies making billions of dollars in profit every single year,” Sanders told CBS News for an interview set to air Wednesday, adding that private insurance would largely exist solely for elective medical care such as cosmetic surgery.

With Sanders’ idea returning to the forefront, Republicans have a fresh opportunity to slam his plan as too costly and unworkable.

“So-called ‘Medicare for All’ means private insurance for none, kicking 180 million Americans off of their current plans,” said Kayleigh McEnany, spokeswoman for Trump’s re-election campaign. “‘Medicare for all’ is a euphemism for government takeover of healthcare, and it would increase wait times, eliminate choice, and raise taxes.”

She touted Trump’s “free market policies” as a better alternative.

Trump has said he will take up health care after next year’s election , essentially making it a central campaign issue. And his administration is arguing in court for the full eradication of the Affordable Cart Act, former President Barack Obama’s signature health care law.

Senate Majority Leader Mitch McConnell, R-Ky., warned in a Tuesday floor speech that the cost of Sanders’ proposal “is so steep that even left-leaning analysts are quietly admitting that the tax burden is virtually certain to land on the shoulders of the middle class.”

Sanders’ office released a paper outlining options to pay for his last version of Medicare for All, estimated to cost upwards of $1 trillion per year, although none of those options was included in the legislation itself. He and other supporters of Medicare for All have generally sidestepped the question of how they would pay for their plan. Instead, they say it offers the best chance for the nation to get control over health care costs by eliminating profiteering. His newest edition of the bill would also cover long-term care, an unmet need for most middle-class families.

Several independent studies of Medicare for All have estimated that it would dramatically increase government spending on health care, in the range of about $25 trillion to $35 trillion or more over a 10-year period. But a recent estimate from the Political Economy Research Institute at the University of Massachusetts in Amherst suggests that the cost could be much lower.

Neera Tanden, president of the Center for American Progress Action Fund, noted the emphasis by most Medicare for All supporters on “multiple pathways” to universal coverage as a potential point of contrast and “fodder for debate” with Sanders. In the absence of former Vice President Joe Biden, who has yet to launch a candidacy, Sanders is leading the Democratic field in early fundraising and campaigning as a front-runner.

“I think it really matters what you say to voters. That’s the most important thing,” Tanden said.

Her group has proposed a Medicare opt-out plan known as “Medicare for America,” supported by former Texas congressman and Democratic presidential candidate Beto O’Rourke, that would allow people to choose to keep employer-sponsored insurance.

Earlier this year, a poll from the nonpartisan Kaiser Family Foundation found that Americans like the idea of Medicare for All but that support flips to disapproval if it would result in higher taxes or longer waits for care.

The poll found initial support of 56% to 42%. But support fell to 26% when people were told Medicare for All could lead to delays in getting care and to 37% when they were told it could mean higher taxes.


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