Sen. Bernie Sanders on Wednesday unveiled legislation that would transform Medicare into a universal health insurance program, laying out an ambitious expansion of coverage that would push the Democratic Party further to the left.
His plan, unveiled with the support of 16 Senate Democrats, sketches out a total makeover of the nation’s health insurance system, replacing nearly all private health plans with a government-run version of Medicare that would guarantee coverage to every single American.
“Health care in America must be a right, not a privilege,” Sanders said in a fiery speech. “Today we begin the debate vital to the future of our economy as to why it is that in the United States we spend almost twice as much per capita on health care as any other nation on Earth, and yet we have 28 million people without health insurance.”
The “Medicare for All” proposal — which is a revised version of the concept Sanders pitched during his 2016 presidential bid — lacks key elements, such as the hefty tax increases that would be necessary to finance such a system, and it has no shot at passage in a Republican-controlled Congress still hoping to dismantle Obamacare.
But it serves as an ideological marker for progressives, who have quickly corralled support from prominent Democrats for a government-run system amid backlash to the GOP’s Obamacare repeal effort. A slew of Democratic senators likely eyeing 2020 presidential bids have signed on as co-sponsors, and for the first time this year, more than half of House Democrats have signed onto similar legislation.
That represents a stark contrast from just a few years ago, when Sanders’ earlier single-payer pitch failed to gain any support from the party. Just last year, Hillary Clinton during the primary slammed the idea as unrealistic and advocated for a more incremental approach to build on the 2010 Affordable Care Act, which expanded coverage to about 20 million Americans.
“I think it is an idea whose time has come,” said Richard Blumenthal (D-Conn.), one of the bill’s cosponsors. “The ACA has been an enormous boon to American health care, and the goal is to build on it.”
The public program would grant individuals generous benefits ranging from surgery to prescription drugs to eye care and eliminate all co-payments, relying instead on higher taxes on Wall Street and the wealthy to fund the trillions of dollars needed to support what would be one of the largest and most extensive social welfare programs in U.S. history.
The plan wouldn’t completely wipe out private health insurance, but it would drastically shrink a system that currently covers more than 170 million Americans through their employers or on the individual market. Under Sanders’ vision, health insurers would likely be relegated to covering elective procedures not covered by the government.
“The average American family will be much better off financially than under the current system because you will no longer be writing checks to private insurance companies,” Sanders said.
His plan is the latest Democratic proposal aimed at expanding health coverage, and is by for the most radical. It would be a longshot for passage even if Democrats wrestle back control of Washington by 2020.
Democrats hesitant to upend health coverage that most people like have instead thrown support behind legislation that expand access to existing government programs. Some proposals would give those as young as 55 the option to join the Medicare program, and Brian Schatz (D-Hawaii) will soon offer a plan giving states the option let their residents buy into Medicaid.
Indeed, even some of the staunchest supporters of Medicare for All described the effort as more aspirational than practically achievable policy in the next few years.
“Quality health care shouldn’t be the providence of people’s wealth. It should be a virtue of us being United States citizens,” said Cory Booker, a co-sponsor and likely 2020 hopeful. “The question is the process of getting there.”
In the interim, the progressive push toward single-payer threatens to make life trickier for Democrats in 2018. Aside from Wisconsin’s Tammy Baldwin, no Senate Democrat facing reelection in a state Trump won signed on to Sanders’ bill. Still, Republicans bludgeoned for months over their own failed health care efforts are sure to seize on the single-payer push as an opportunity to link vulnerable Democrats to a concept they’ve long derided as socialized medicine.
“I can’t think of anything worse than having the government be more involved in your health care instead of less involved,” said White House press secretary Sarah Huckabee Sanders.
Jon Tester, one of the vulnerable Democrats facing reelection in 2018, said he won’t support the Sanders plan.
“I support fixing what we’ve got, because I think that’s more likely to happen,” he said, referring to the ACA.
Democratic leaders in Congress have also shied away from embracing a fully government-run health care system. Senate Minority Leader Chuck Schumer said Medicare for All is just one of many options on the table for expanding coverage, and Nancy Pelosi this week said she’s focused on protecting Obamacare from repeal efforts.
On the same day that Sanders introduced his bill to a packed room of supporters, Bill Cassidy and Lindsey Graham published their own bill that would dismantle Obamacare in favor of sending block grants to states.
The Sanders plan has also drawn sharp pushback from health insurers, who have played a key role in supporting and preserving Obamacare. Single-payer would represent an existential threat to the insurance industry.
“It’s going to cost trillions of dollars, more taxes and it’s going to increase waste, fraud and abuse,” said David Merritt, an executive vice president at America’s Health Insurance Plans.