On February 27, 2019, Pramila Jayapal, an American politician and activist from the state of Washington, along with 106 co-sponsors, introduced the Medicare-for-All Act for 2019. This new bill will build upon the previous House single-payer legislation, which was led by Rep. John Conyers (D), who is now retired.
Members of the House presented their version of the bill which is broader than that was put forth by Sen. Bernie Sanders. This bill is meant to transform the healthcare system into a single-payer system and will help to redefine what the change in healthcare coverage could mean for Americans.
This bill could also potentially take part in the upcoming Democratic presidential primary campaign. More on this below.
Why Does This Bill Matter?
Many Medicare-for-all proposals have been presented in the past, so what makes the bill proposed by Pramila Jayapal unique? Jayapal’s proposal includes provisions that were not presented in the other proposals. The term “Medicare-for-all” usually means that the plan would basically provide all forms of medical care for all citizens. The bill proposed by Jayapal targets one of the biggest controversies: the role of private healthcare. Jayapal’s bill permits private healthcare.
Under this new plan, citizens would not be required to pay any costs related to medical expenses including: hospital visits, doctors, prescription medication, including vision and dental care. This also includes the cost for preventive care. This new plan would cover senior citizens by folding them into the new Medicare plan. The House Bill includes language that could potentially reduce high prices for prescription drugs by enforcing government negotiation of prices directly with the manufacturers.
Similar to the Sanders Bill, the House legislation covers what is known as ‘the comprehensive reproductive health plan’. Those in favor of the bill presented by Pramila Jayapal say that it is meant to cover abortion. This is a very controversial provision at the moment since current health plans funded by the government prohibit funds for abortions.
Pro-choice America CEO and President (NARAL), Ilyse Hogue, said in a statement, “Representative Jayapal has been an unwavering champion for women and reproductive freedom and we applaud her leadership today”. Hogue recognizes the efforts put forth by Jayapal and applauds her for affirming every woman’s right to reproductive healthcare.
The biggest difference between this new bill and the one by Sanders is that the bill presented by the House members would cover long-term care which is not part of the Sanders bill and is currently not covered by Medicare. This would be a huge benefit for people with disabilities and older individuals who currently pay for long-term services out-of-pocket.
Many have advocated for the Medicare-for-All bill proposed by Jayapal, but there are some who question the provisions it offers, especially the reproductive system coverage that includes coverage for abortion.
Advocates for “Medicare-for-All” say that Medicare will update the United States to a system where healthcare is universal, making it similar to the rest of the industrialized world. This will help to save money and improve healthcare outcomes of Americans. Others, against the Medicare-for-All mention that it is too expensive and that they believe there are other cheaper alternatives that could provide the same outcomes.
The idea of including long-term coverage is very attractive to many, including Robert Blendon who is a Harvard T.H. Chan School of Public Health healthcare pollster. He says, “The long-term care piece is unbelievably significant… It surely will help [progressives] with older voters.” He believes that the long-term care benefit could attract older voters who are currently hesitant to change their coverage.
A few years ago, Sanders was the only Senate Democrat who supported the single-payer system. There are currently at least 15 Senate Democrats who have supported this plan. Opposers to the bill question whether it will provide any benefit.
The chief engagement officer at Americans United for Life, Tom Shakely, questions the need to retain the Hyde amendment and is concerned that the bill’s main aim might be to get rid of private insurance. He believes this could have serious consequences for healthcare. “Every American of goodwill endorses medical care for all persons who need care, but Medicare for All’s regressive approach would create a single and unaccountable government monopoly on healthcare,” Shakely says in a statement.
Redefining the Change in Healthcare Throughout the 2020 Campaign
This House bill highlights current issues in the healthcare discussion, but requires Democratic presidential primary candidates to propose their stances on the policy. This bill is controversial; many oppose it because of such clauses that include coverage of abortion. Its inclusion of long-term care coverage, could exponentially increase the dollar price tag.