Rep. Pramila Jayapal, a Democrat from Washington and the co-chair of the Progressive Caucus, unveiled Wednesday the most ambitious Medicare-for-All legislation the country has ever seen with the support of Rep. Debbie Dingell and more than 100 House Democrats. The bill aims to transition the United States to a single-payer healthcare system over a two-year period and includes benefits that are more generous than even the proposal championed by Sen. Bernie Sanders.
"We have the most expensive healthcare system in the world and yet our outcomes are the worst of all industrialized countries. I and the more than 100 co-sponsors of this bill refuse to allow this to continue. It’s time to put people’s health over profit," Jayapal said in a statement provided to Refinery29. "Our bill will cover everyone. Not just those who are fortunate enough to have employer-sponsored insurance. Not just children. Not just seniors. Not just those who are healthy. Everyone. Because healthcare is a human right."
The Medicare for All Act of 2019 would establish a system where all Americans would receive health insurance coverage through a single, government-run plan. Countries such as Canada, the United Kingdom, and Denmark offer single-payer systems. In the U.S., the idea has gained traction in recent years: A 2018 Reuters poll found that about 70% of Americans support Medicare for All, but support drops when those polled are presented with the idea of higher taxes to pay for the system or longer waiting periods to obtain care.
The legislation would cover every American — which would mean that Medicare and Medicaid beneficiaries would be absorbed under the universal plan — and dictates that employers are banned from offering separate healthcare options. The government-run plan would cover everything from hospital visits and primary care to other benefits such as maternity care, prescription drugs, nursing and lab services, medical devices, and vision and dental coverage. The legislation also says that consumers wouldn't be required to pay out-of-pocket for any of these services, except for prescription drugs.
Jayapal's also goes further than previous proposals by including coverage for abortion care, which would mean the Hyde Amendment — which bans the use of all federal funds for abortion care — would need to be reversed. NARAL Pro-Choice America President Ilyse Hogue celebrated the initiative, saying in a statement provided to Refinery29: "Rep. Jayapal’s Medicare for All proposal recognizes the simple truth that women will never be equal members in society until we have full access to reproductive healthcare. Put simply, a right is not a right if you cannot access it." She added: "At a time when women’s reproductive freedom hangs by a thread, Rep. Jayapal’s proposal draws a line in the sand, sending a clear message that women’s rights are not up for debate."
What's not entirely clear is how the government would pay to establish and maintain a single-payer healthcare system. Jayapal suggested that a "wealth tax" (similar to that proposed by Sen. Elizabeth Warren) and mandatory employer contributions, combined with savings generated by reducing costs and fixing the current healthcare system, would accomplish this goal.
Several high-profile freshman members of the House such as Reps. Alexandria Ocasio-Cortez, Ilhan Omar, and Katie Hill, signed on to the bill, but not all Democrats are on board with the plan. Lauren Underwood from Illinois told CNN she's more focused on expanding the Affordable Care Act and lowering drug costs, a priority shared by other Democratic members of Congress. Even if it passes the House, the proposal is also likely dead-on-arrival once it's sent to the Republican-controlled Senate; it also has no support from the Trump administration.
Progressives should also expect pushback from the healthcare industry, which recently created a new coalition made up of hospitals, insurers, and drug manufactures to fight any type of single-payer push. But Jayapal said in a statement that she's ready for it.
"We will need every single person in the country to help us, to stand with us, to organize, and to fight for this. Because the industry lobby is going to pour hundreds of millions of dollars into killing this bill, saying it costs too much, scaring you into thinking you’re giving up something, pitting the healthy against the sick and the young against the old," she said. "It’s time to ensure that healthcare is a right and not a privilege, guaranteed to every single person in our country. It is time for Medicare for All."