Breaking Down the Medicare for All Plan

• Medicare for All is essentially a single-payer healthcare system that implements universal health insurance coverage for every United States (U.S.) citizen. 

• This proposed healthcare program would include many changes including services provided, enrollment layouts, etc. 

Medicare for All is a proposed national health insurance program that would provide universal healthcare for every United States citizen. Those who support Medicare for All believe that healthcare is a human right. In guaranteeing health care for all citizens, Medicare for All would help public health and lower health disparities. Those against Medicare for All say the single-payer system would cost too much money.

This article will explain everything there is to know about the Medicare for All Act. 

To understand Medicare for All, it’s important to understand the Federal Medicare Program first. Medicare is a federal health insurance program that provides health coverage for adults ages 65 and older, younger people with disabilities, and people with end-stage renal disease (ESRD).

Medicare is broken into various Parts, each one covering specific health and medical services:

• Medicare Part A (hospital insurance)

• Medicare Part B (medical insurance) 

• Medicare Part D (prescription drugs)

Medicare started in 1965 under the Social Security Administration. It is not administered by the Centers for Medicare and Medicaid. 

Note: Learn more about the history of Medicare at this resource.

Medicare for All is a legislative push in the United States to implement a new universal, single-payer national health care system. If the plan is accepted, it would guarantee health care for every U.S. citizen that is fully funded by the federal government.

The reason the plan is called ​“Medicare for All,” is because its universal nature resembles that used within the Medicare/​Medicaid plans already implemented within the U.S.

It is currently ​“endorsed by more than 60 major organizations” such as National Nurses United, American Medical Student Association, Nation Union of Health Care Workers, Service Employees International Union (SEIU), Association of Flight Attendants-CWA (AFA-CWA), Indivisible, Public Citizen, People’s Action, National Immigration Law Center, Center for Popular Democracy, and Working Families Party. A big proponent of the plan is Senator Sanders that stated, ​“The American people understand, as I do, that health care is a human right, not a privilege and that we must end the international embarrassment of the United States being the only major country on earth that does not guarantee health care to all of its citizens,” to which many people for the plan, agree with.

In order to understand Medicare for All, it’s essential to understand the single-payer health care system. A single-payer healthcare system is a type of universal coverage for citizens of a country. A single-payer healthcare system is financed by a single public or quasi-public agency (i.e. the federal government).

Note: To learn more about single-payer healthcare systems, visit this source.

Medicare for All differs from the Affordable Care Act (ACA). Medicare For All encompasses providing health care coverage for all U.S. citizens, while the ACA focuses on providing healthcare coverage for those who were unable to access it through their job or low-income persons. 

The Affordable Care Act is the most recent attempt at health reform in the United States. Under the ACA, all health care plans must cover 10 essential health benefits including emergency services, mental health, maternity and newborn care, etc. 

Note: Learn more about essential health benefits under the ACA at this resource.

Once the plan’s basics are understood, it’s essential to break down each part of this single-payer health care system to get a comprehensive overview of how it functions.

What kinds of health services are covered?

Within this universal, national health insurance program, all health care services are covered including prescription drug coverage. This means that health care costs are negligible when it comes to out-of-pocket costs or fees. At a glance, services include:

• Hospital Inpatient & Outpatient Services

• Ambulatory Services

• Primary & Preventive Care Measures

• Prescription Drugs

• Medical Equipment

• Mental Health Treatment

• Substance Abuse Treatment

• Lab & Diagnostic Services

• Reproductive & maternity Care

• Newborn & Pediatric Care

• Dental Services

• Hearing Services

• Vision Services

• Short-term Rehabilitation

• Emergency Care

• Home or Community-Based Long-term Care

Under Medicare for All, the Hyde Amendment would be eliminated, allowing the government to fund treatments such as abortion. Furthermore, transportation for disabled or low-income persons would also be provided if further assistance is needed to access care.

What kind of providers are covered?

The Medicare for All act encourages patients to select any provider they choose. Within the act, a patient’s unrestricted ability to choose who they receive care from is referred to as the “freedom of choice.”

If implemented, could private insurance still be purchased?

The overall goal when implementing Medicare for All is to eventually eliminate private insurance altogether. However, during the two-year transitionary period, private insurance will still be available. Once the transitionary period ends, patients are allowed to enter into direct-pay private contracts with private insurers if they choose but their healthcare costs for this plan may likely be much higher.

How will we transition into Medicare for All?

The healthcare plan will take track of transitioning through a two-year enactment period. For the general public, the plan’s full benefits will take effect two full years after the Medicare for All enactment date. However, coverage will begin one year after the enactment date for those that are 18 years or younger, 55 years or older, or are already enrolled in Medicare. During the two-year transition period, any individual is welcome to continue receiving coverage through private health insurance companies or other options.

Will people be able to opt-out of this healthcare plan?

No, however, individuals may still enter into direct-pay private contracts after the transition period is over. That being said, the bill states that with all U.S. citizens being covered under the plan for universal healthcare, no person is able to opt-out of paying the taxes necessary to finance the plan.

How will Medicare for All affect healthcare providers?

The salaries of healthcare providers will be switched to a schedule arranged by the Health & Human Services department. In addition to this, national standards would be put in place to ensure providers are unable to charge patients with extra fees.

How much will Medicare for All cost?

For patients, there would be no out-of-pocket costs for their health care. However, the Center for Medicare and Medicaid estimated that, as a country, the plan would cost $47 trillion over a ten-year period.

How is Medicare for All funded?

Many options have been discussed such as payroll taxes, increased taxes on high-income individuals, and/or fees on major financial institutions. However, at this time, no option has been set in stone for funding.