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Medicare-for-all Revives Healthcare Debate, Could Threaten Providers

By Gregory A. Freeman  
   April 25, 2018

Democrats are pushing for a Medicare program that would cover all Americans, a change that would rattle the healthcare industry. Uncertainty over how quickly to proceed may slow their efforts.

The debate over healthcare reform has died down in recent months after the Trump administration systematically dismantled some of the key components of the Affordable Care Act, but legislators are keeping the heat on with Medicare-for-all plans that would amount to a huge shake up in the healthcare industry.

The question for Democrats is when to bring them to the forefront and work for a healthcare change that would rival what happened with Obamacare.

Democrats will promise great benefits to consumers and make healthcare reform the No. 1 topic again, but if Medicare displaces private health plans an alarming number of healthcare professionals are likely to flee for early retirement or change careers, according to an industry thought leader.

There are currently four proposals with variation on the idea of making Medicare available to all Americans, the most prominent from Sen. Bernie Sanders (I-VT), which proposes Medicare for All by transitioning the country to a single-payer health system, which has the support of 15 senators.

Sens. Michael Bennet (D-CO) and Tim Kaine (D-VA) are still proposing their Medicare X plan, which calls for making Medicare available as an option but not the only payer.

The liberal Center for American Progress is proposing Medicare Extra for All, and Sens. Chris Murphy (D-CT) and Jeff Merkley (D-OR) recently offered another new Medicare buy-in plan called the Choose Medicare Act.

In addition, Sen. Brian Schatz (D-HI) and Rep. Ben Ray Luján (D-NM) are still supporting their  State Public Option Act, which would create a Medicaid-based public healthcare option on the insurance marketplace.

Democrats see opportunity

With the ACA significantly weakened but no indication that the Republicans will be able to fully repeal and replace it, Democrats are seeing the opportunity to push the single-payer system many of them favored all along, says Sally C. Pipes, president and CEO, Thomas W. Smith Fellow in Health Care Policy at Pacific Research Institute.

The variety in the bills, however, shows that Democrats aren't sure how much they can seek a complete change in how Americans pay for healthcare.


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Gregory A. Freeman is a contributing writer for HealthLeaders.

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