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A New Version of Medicare for All Is Set to Go Even Further Than Bernie Sanders’ Proposal

Do you support Medicare for All?

by Axios | Updated on 2.27.19

Even Sen. Bernie Sanders can get outflanked in the race to define Medicare for All as Rep. Pramila Jayapal (D-Wash.) is set to introduce a bill today that would go even further than Sanders' sweeping proposal.

Why it matters: Even as moderates and more conventional liberals are freaking out over the politics of such a dramatic upheaval, the left is still moving left, laying down ever-more-ambitious markers as they gain more and more influence over their party.


  • Many of the broad strokes are the same: Both bills would eliminate most private insurance and most existing federal health programs, moving everyone in the country into a new single-payer system. Neither would allow co-pays or deductibles.
  • Jayapal's version, though, would cover some things Sanders' bill wouldn't — most significantly, long-term care like nursing homes. It also calls for a 2-year phase-in period, compared to Sanders' 4 years.

What we don’t know: The cost.

  • Sanders' bill would cost about the same as the status quo; money we're currently spending on premiums and out-of-pocket costs would need to be turned into taxes.
  • Jayapal's bill is more expansive than Sanders' and therefore would likely be more expensive. But it doesn't have a price tag yet, nor does Jayapal have a plan to cover whatever that cost may be.

What we're watching: For my money, the most interesting policy component of this bill is the way it would control health care spending.

  • Jayapal would put hospitals and nursing facilities under a "global budget" — a firm cap on how much the program will spend each year, which would be divvied up in lump sums each quarter. (Maryland has a similar system.)
  • Individual doctors, meanwhile, would be paid for each service they provide — a return to the fee-for-service model the existing Medicare program is trying to abandon.

Go deeper: What "Medicare for All" could look like

Axios

Written by Axios

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(66)
  • Stewart
    Voted Yes
    02/27/2019
    ···

    Someone has to pay for it but it’s not gonna be me is not how a functioning society works. If that’s your worldview stop using the roads I pay for to get to work, you better not collect that fucking social security retirement check I’m paying for, don’t call the police or the fire department either. Selfish people cannot contribute to society therefore they should get none of the benefits of being a part of it.

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  • Nancy
    02/28/2019
    ···

    Because of incredibly high insurance premiums, which prevents many people from buying insurance for themselves, we need to look at ways to bring those premiums down. The insurance companies, and their executives earn a great deal of money - they don't need such high prices, which prevents many people from buying insurance to help them out through their medical issues.

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  • Terry
    Voted No
    02/27/2019
    ···

    Govt. controlling your life ? NO !

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  • RjGoodman
    Voted Maybe
    02/27/2019
    ···

    I understand that by defining “Medicare for all” these candidates would have to justify what they want to do. Until it is defined, all of this talk is nothing but hot air. Give us a definition! Then let’s talk...

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  • Rebekah
    Voted Yes
    02/27/2019
    ···

    Insurance companies are obscenely profitable, and make even more when they deny medical care. Medical bills are the #1 reason Americans go bankrupt. Single payer is the ONLY option to fix this. Every other industrial nation knows this but our politicians on both sides of the aisle appear to be bribed by Big Pharma & Insurance. Vote Single Payer or we will vote you out!

    Like (8)
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  • John
    Voted No
    02/27/2019
    ···

    Somebody has to pay for it and I don’t want that to be me

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  • Scott
    Voted Maybe
    02/27/2019
    ···

    I support the Bernie version of Medicare for All. It has the lesser strain on US Citizens, financially, and would be the better test model. Run through that idea rather than a more advanced, possibly more expensive (for less overall gain) model. See if it works. If it does, run test cases of more expansive models

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  • Donna
    02/27/2019
    ···

    I am conflicted on this issue. First of all, everyone needs to know, currently, Medicare is not free. We pay in on our paychecks. When we are of retirement age, we still pay for it. Next, my husband’s UHC through the firefighters union costs him hardly anything. It does cost a lot to be on his plan. But a few medical visits later, I haven’t had to pay. So, what happens to all the money paid into Medicare and money paid into the firefighters self funded plan(inMiami, Fla. Don’t know if that is the same for all firefighters in the country) I’m also conflicted re the insurance companies. Yes, I hate the greed and gouging. But, I wonder about free enterprise. Can the insurance companies be reined in and more regulated? Also, perhaps a gradual phase in if we go to single payer? I know true Medicare for all will raise taxes a lot. Will this balance out by no more premiums, no co pays, no deductible S? Will it allow alternative choices such as acupuncture, Naturopathic doctors, massage therapy, etc.? Nursing home care? Hospice? Visiting nurses or aides? Help at home with chores? Will we continue to pay in on our paychecks, or one big tax bill? I know this is a very complex issue. I don’t have the answers. I do think it is not something we should rush for politics sake. I think the Dems should all get together and come up with some actual plans and let the people see the various plans and ideas. Then maybe we, the people should vote on the plans, plan A, Plan B, etc. give us a good explanation for each possibility and how much it will cost us, total. I think a big help will come with taxing the Uber rich to help pay. They have been getting away, far to long not paying their fair share, not paying at all due to loop holes, and/or parking their money offshore. I can say, take your time(not too much) work together and whatever you come up with, or we vote in, it should probably be a gradual phase in. Good luck!!! .

    Like (2)
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  • Steve
    Voted Yes
    02/27/2019
    ···

    This should have been established decades ago.

    Like (6)
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  • Rick
    Voted Yes
    02/27/2019
    ···

    Makes more sense than a stupid wall.

    Like (5)
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  • I.Got.an.Idea...
    Voted Yes
    02/28/2019
    ···

    Just give every Citizen the same healthcare benefits that Congress has, except, provide it via the Government and remove all private insurers, except for elective and choices beyond the greatest universal healthcare care in the world.

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  • Raxynus
    Voted Yes
    02/27/2019
    ···

    I’m so proud of my representative in Washington taking a stand to work with and for the people!

    Like (5)
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  • PLD
    Voted Yes
    02/27/2019
    ···

    Proper healthcare is a right that should be upheld by the government for all.

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  • Timothy
    Voted Yes
    02/27/2019
    ···

    I support the most comprehensive version of Medicare for All that can be passed

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  • amarvin
    Voted Yes
    02/28/2019
    ···

    Lives are worth too much to not do this.

    Like (4)
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  • Carmine
    Voted Yes
    02/27/2019
    ···

    And you don’t like it you can opt into a higher end plan you pay extra for

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  • Kara
    Voted Yes
    02/28/2019
    ···

    I support Medicare for All 100%! It's a HUGE embarrassment that we let people die simply because they can't afford medicine and surgeries while every other civilized nation refuses to allow that. We CAN do it but our elected officials are beholden to the greedy pharmaceutical industry and they put their needs first. (Votes for money!) It's time to make some changes America. Change Congress, change the country. For the better.

    Like (3)
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  • Kathryn
    Voted Yes
    02/27/2019
    ···

    Kill the predatory health care insurance industry! Medicare for All is the government paying for our healthcare with our taxes - NOT the government taking over healthcare. Americans already pay 2X as much as any other industrial country and get far worse outcomes. Medicare for All would save Americans trillions, but put insurance CEOs who make $22 million a year out of business and politicians who those CEOs bribe, which is why they gaslight you about your health care.

    Like (3)
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  • Shawn
    Voted Yes
    02/28/2019
    ···

    Do it.

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  • Daniel
    Voted Yes
    02/28/2019
    ···

    We’re the only major country in the industrialized world NOT to have a healthcare system that is similar to Medicare for All. The American people deserve Medicare for All in order to worry about recovering and receiving medical care, not how much getting treatment is going to cost them.

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  • John
    Voted Yes
    02/27/2019
    ···

    While working on universal single payer healthcare, cradle to grave.

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  • MsStewart
    Voted Yes
    02/28/2019
    ···

    Medicare for all will actually help our economy. Believe that.

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