This week, Rep. Pramila Jayapal (D-WA) introduced “The Medicare For All Act Of 2019,” the latest iteration of Democratic efforts to turn health care in America into a single payer system. According to Vox, the bill would “transition the United States to a single-payer health care system, one in which a single, government-run health plan provides insurance coverage to all Americans.” The plan would completely pay for health care expenses including hospital visits, primary care, medical devices, lab services, maternity care, prescription drugs, and vision and dental benefits. It also includes coverage for long-term nursing services and abortion. Jayapal succinctly noted her intentions with the bill: “We mean a complete transformation of our health care system and we mean a system where there are no private insurance companies that provide these core benefits.”
The bill will almost certainly become a top issue through the 2020 election, as Democratic candidates try to balance appeasing their liberal bases and their more moderate supporters. With this in mind, AR Intel has pulled together the 4 main things you should know about the far-left’s latest attempt at a government takeover of health care.
Big Price Tag, No Pay-For
The health care system Jayapal is proposing shares many similarities with the bill put forth by Sen. Bernie Sanders. However, Jayapal’s bill goes a step further by offering additional benefits like coverage for long-term care for nursing services. A 2016 study of Sen. Sanders’ health care plan by the Urban Institute estimated that it would cost a whopping $32 trillion over the next ten years. Given that Jayapal’s plan is offering more generous benefits than Sanders’, we can almost certainly predict that the new bill will come with a higher price tag.
The kicker, though, is that Jayapal’s proposal says nothing about how it will be paid for. With a price tag upwards of $32 trillion, supporters of the proposal will need to come up with some more concrete details about how they intend to pay for the new health care system without bankrupting the country.
Democratic Tax Proposals Wouldn’t Be Able to Cover The Cost
When asked about how the bill would be paid for during a call with the press, Jayapal floated the idea of instituting a wealth tax and repealing the Tax Cuts & Jobs Act, but did not have any concrete proposals. Over the last few months, several national Democrats have proposed new tax increases on the wealthy that they’ve trumpeted as ways to pay for progressive policies. The problem, however, is that none of the tax proposals would come close to paying for a $32 trillion single-payer system.
Rep. Alexandria Ocasio-Cortez’s proposed marginal tax rate of 70% on income over $10 million would produce around $70 billion per year, far short of the amount needed. Sen. Elizabeth Warren’s proposed wealth tax would raise $2.75 trillion over a decade. And Sen. Bernie Sanders’ estate tax increase would only raise about $315 billion over the next ten years.
Lost Jobs & Lost Coverage
Since her bill shifts the burden of health insurance from the private sector to the federal government, Jayapal estimated that 1 million to 2 million people in the private heath insurance industry could lose their jobs due to her proposal. The bill includes a provision to provide funding for “wage replacements,” retirement benefits, and job training for displaced workers, but it’s unclear how much these provisions could cost.
In addition to “sunsetting” Medicare and Medicaid, Jayapal’s bill bars employers from offering separate plans that compete with this new, government-run option. According to The Guardian, “Half of Americans – more than 155 million – have employer-sponsored health insurance. Polling suggests that they, by and large, like their plans and want to keep them.” Democrats could be in for a public relations battle with voters if they insist on kicking people off health care plans they already are happy with.
Although public support for a single-payer system has increased over the last several years, surveys also show that support drops if respondents hear that the plan would result in higher taxes or longer waiting times for treatment.
Two states faced that reality recently when they tried to institute their own local version of single-payer. In 2014, Vermont tried to implement a single-payer plan only to see the plan fall apart after state legislators realized they would need to increase payroll taxes by 11.5% and increase the income tax by 9%. In California two years ago, state legislators scrapped a $400 billion single-payer plan because of its high cost.
Any voter concerned about wait times should look no further than the government run health care system in the United Kingdom. Figures released by the National Health Service in 2017 showed that patients were increasingly having to wait for longer periods before seeing their doctor, with some people unable to get any appointments, forcing them to turn to emergency departments.
The cosponsors for Jayapal’s bill include many members you would expect; Reps. Alexandria Ocasio-Cortez (D-NY), Ilhan Omar (D-MN), Ayanna Pressley (D-MA), and other far-left progressives. However, there are some members who have signed onto the bill that may raise an eyebrow.
First, there’s Rep. Ruben Gallego (D-AZ). Gallego is widely known as a progressive member of Congress and signing onto this bill doesn’t necessarily come as a surprise. What will be interesting to watch, however, is how this bill impacts the Arizona Senate race. Gallego has been openly mulling a bid for Senate as the progressive alternative to the more establishment Mark Kelly. If Gallego does in fact get into the race, it will be interesting to watch how he uses his support for Medicare for All to draw a contrast with Kelly, who has yet to take a stand on the issue.
There are also a number of members who have signed onto the bill that are looking at close reelection campaigns next year. Reps. Jared Golden (D-ME), Josh Harder (D-CA), Katie Hill (D-CA), and Katie Porter (D-CA) all have races that are considered vulnerable by the Cook Political Report. Any credible Republican challenger to these members will almost certainly use their sponsorship as a line of attack.