Rep. Pramila Jayapal, D-Wash. (Photo: Jayapal)
A leader of House Democrats' progressive wing is proposing "Medicare for all" legislation that would replace almost all private health insurance, an idea that's galvanizing the party's liberal base and winning endorsements from many of its top presidential contenders.
The legislation by Congressional Progressive Caucus co-chair Pramila Jayapal would steer all Americans — not just those 65 and older — into the Medicare program in two years. It would cover comprehensive health care services and, in a radical departure from the existing system, limit private insurance to supplemental benefits not provided by the government-run program.
"The state of our health care system is absolutely atrocious," Jayapal of Washington told reporters on a conference call Tuesday. "Americans are literally dying because they can't afford insulin or they can't get the cancer treatment they need. Americans are going bankrupt."
She said the measure will be introduced Wednesday with more than 100 co-sponsors.
Jayapal didn't say how much it would cost or how it would be funded. The measure would eliminate all premiums, deductibles and co-pays while guaranteeing universal health care access to "every person living in the United States," according to a summary provided by Jayapal's office. The summary said combining all coverage into one program would reduce administrative costs and let Medicare set doctors' fees, hospital budgets, and negotiate drug prices.
A member of Jayapal's staff said options for financing the plan include a wealth tax, higher marginal tax rates and repealing portions of the 2017 Republican tax cuts. While the proposal would dramatically raise the government's tab on health care, the staff member, who spoke on condition of anonymity, suggested that overall U.S. spending on health services would fall.
Presidential Contenders
A small private insurance market for services not covered by Medicare wouldn't receive any federal funding under Jayapal's plan.
Democratic presidential contenders who support the idea of Medicare for all include five senators — Vermont's Bernie Sanders, Massachusetts's Elizabeth Warren, New York's Kirsten Gillibrand, New Jersey's Cory Booker and California's Kamala Harris — as well as Julián Castro, a former cabinet secretary in the Obama administration. Candidates are being quizzed about the issue on the campaign trail.
Harris drew applause Saturday at a town hall in Ankeny, Iowa, when she touted Medicare for all as a mechanism to cut costs on emergency room visits by people who currently lack coverage. She said it would also let the government take on drug companies that "dictate prices" to make money.
"The pharmaceutical companies have been gouging us, guys," she said. "With Medicare for all, when fully achieved, everyone would be in the system and then we can negotiate as a big group against the pharmaceutical companies to bring down those prices."
Not all Democratic presidential contenders endorse the idea. Minnesota Senator Amy Klobuchar, who portrays herself as a pragmatist, said at a recent CNN town hall that Medicare for all "could be a possibility in the future" but she doesn't view it as realistic now.
No Realistic Chance
For now, Medicare for all has no chance of becoming law in a divided Congress. Democrats control the House but Speaker Nancy Pelosi and a number of party moderates are resisting the idea. On Tuesday, a member of the House Democratic leadership, Hakeem Jeffries of New York, kept his distance from the proposal, saying the Democratic caucus supports universal coverage but wants to focus on strengthening the 2010 Affordable Care Act and lowering drug costs.
