Senate Democrats’ support for single-payer healthcare grows
Thursday, September 14, 2017
On Sept. 13, Sen. Bernie Sanders (I-Vt.) introduced his Medicare for All Act of 2017, which has the support of 16 Senate Democrats so far. His bill would extend Medicare — the health insurance program for Americans age 65 and up — to the entire U.S. population, phased in over a four-year period.
Under the Medicare for All Act of 2017, Uncle Sam would be the lone insurer to pay medical providers, e.g. doctors, hospitals and medical equipment makers.
"Instead of wasting hundreds of billions of dollars trying to administer an enormously complicated system of hundreds of separate insurance plans," Sanders said, "there would be one insurance plan for the American people with one single payer."
That system would eventually extend healthcare to the 28 million Americans who lack it now under the Affordable Care Act, or Obamacare, which the current Republican-led Congress has tried and failed to repeal.
"We could not be more proud of Sen. Sanders for his enormous effort to solve once and for all an urgent issue that touches every American family," RoseAnn DeMoro, head of National Nurses United, an activist labor union, declared in a statement.
Not everyone is on board, however. Sanders' bill would eliminate private insurers, and the powerful health insurance industry will fight that option, its death sentence.
"Whether it's called single-payer or Medicare For All, government-controlled healthcare cannot work," said David Merritt, executive vice president at America's Health Insurance Plans (AHIP). "It will eliminate choice, undermine quality, put a chill on medical innovation, and place an even heavier burden on hardworking taxpayers.
"We should build on private-sector successes, not abandon them."
The Medicare for All Act of 2017 has no chance of passage in the GOP-controlled Congress. The bill, however, is important as a value statement for the aspiration of universal healthcare coverage, said Anthony Wright, head of Health Access California, an advocacy group.
Don McCanne, M.D., a member of Physicians for a National Health Plan, a single-payer advocacy group, compared the Medicare for All Act of 2017 as a sister bill, though not exactly similar, to Rep. John Conyers' (D-Mich.) H.R. 676, The Expanded and Improved Medicare for All Act. His legislation "currently has a record 117 co-sponsors in the House," according to Margaret Flowers, M.D., a PNHP member like McCanne.
The independent Congressional Budget Office does not yet have a cost estimate for H.R. 676.
Single-payer healthcare has also seen some movement at the state level. In the blue state of California, Sen. Toni Atkins (D-San Diego) and Ricardo Lara (D-Los Angeles) introduced a single-payer bill — S.B. 562 — this spring, but it was halted in the state Assembly after passage in the Senate.
Assembly Speaker Anthony Rendon (D-Los Angeles) ended discussion of S.B. 562, while Democratic Gov. Jerry Brown lamented the high price of single-payer healthcare. S.B. 562 will remain parked in the state Assembly for one more year, according to McCanne, who says the federal government has skin in this game.
"A single-payer system on the state level requires major federal legislation to move ahead," McCanne said. "Since the existing waiver programs do not allow states enough flexibility over use of funds for Medicare, Medicaid and ACA subsidies, we would need federal legislation that would allow California to use those funds for its single-payer program. We would also need relief from the federal Employee Retirement Income Security Act of 1974 law."
ERISA establishes minimum standards for almost every voluntarily-created health and pension plan in private industry (which employs a majority of the U.S. labor force) to protect covered individuals in these plans.
"The ERISA currently limits state oversight of employer-sponsored health plans," McCanne said.
In the current political climate, it is important to flesh out the details of a single-payer healthcare system, according to Wright. Sanders' Medicare for All Act of 2017, if nothing else, seems to be a national step in that direction.
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