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When Joe Biden became the Democratic Presidential nominee last year, it was assumed that talk of Medicare for All was effectively dead. The concept, popularized by Vermont Senator and former presidential candidate Bernie Sanders, would have created a government-run, national healthcare coverage that would all but upend the health insurance industry.
Now, Medicare for All is back in the national conversation after two Democratic congress members, Pramila Jayapal of Washington and Debbie Dingell of Michigan, introduced the Medicare for All Act of 2021. According to The Washington Post, it was floated to the chamber on Wednesday, a year after the first COVID-19 cases were confirmed in all 50 states and D.C.
In a tweet sent this week, Dingell said the bill would guarantee access to healthcare without the threat of going broke. "In the wealthiest country in the world, people shouldn't be launching GoFundMe pages to pay for lifesaving healthcare," Dingell tweeted.
Echoing those sentiments, Jayapal said during a live stream this week that the coronavirus pandemic in particular has cast a spotlight on the deficiencies of the country's for-profit health system.
"We were already leaving nearly half of all adults under the age of 65 uninsured or underinsured before COVID-19 hit," she said. "And that was happening while we paid double more per capita for healthcare than any other country in the world."
WHAT'S THE IMPACT?
How far the bill is likely to go remains uncertain, given that there will almost assuredly be no bipartisan support. The bill has 109 sponsors – all Democrats – and a majority of the party's House caucus.
But chances are good that, if the bill even makes it our committee, it will be met with opposition from every Republican member of the House, and a handful of Democrats as well.
Gaining traction in the Senate would be an even steeper climb, given that chamber's 50/50 split and the likelihood that at least one Democrat would vote against the measure.
And in the very off-chance that the bill makes it to the president's desk, there's no guarantee that Biden would sign it, considering he spent much of his campaign pushing instead for a strengthening of the existing Affordable Care Act.
The GOP has attempted for years to repeal the ACA, but has thus far been unsuccessful in creating an alternative plan.
THE LARGER TREND
Based on 2019 surveys in a HealthPrep Data Service report, optional Medicare for All was the most popular policy among respondents at 45.4%. Keeping the current private system intact came in second, at 33.3%, while a mandatory Medicare for All system garnered the least support, at 21.2%.
This suggests that, while there's public support for a shift to some form of universal healthcare, voting-age Americans are wary of a complete break from the current system. In short, a majority of voters reject mandatory Medicare for All, while a majority support a Medicare for All option.
Most of the healthcare industry stands opposed to Medicare for All. Payers are against a plan that would eliminate private insurance. Hospital providers say a government-run health plan would ultimately result in lower reimbursement.
Responding to a 2019 bill introduced by House Democrats, the American Hospital Association said Congress has a history of slashing provider payments for government health programs and that Medicare and Medicaid reimburse providers less than the cost of delivering care.
"America's hospitals and health systems are working with policymakers to help expand coverage and improve affordability for all Americans," said AHA EVP Tom Nickels in 2019.
"However, we are opposed to 'Medicare for All,' as it would impede our shared goals. The AHA believes there is a better alternative to help all Americans access health coverage – one built on fixing our existing system rather than ripping it apart and starting from scratch."
The Federation of American Hospitals said it opposes legislation that would upend coverage for hundreds of millions of Americans, eliminate private health insurance and lead to a massive disruption in care for patients.
America's Health Insurance Plans is against what it calls the one-size-fits-all government system. Under current coverage, Americans have choice and control over their options and treatment, AHIP said.
The ACP's reasons were numerous, as the group said such a policy would lower administrative costs and reduce barriers to care access. Physicians are becoming increasingly frustrated with the paperwork that comes with having multiple insurers with multiple rules and documentation requirements.