Medicare-for-All is sure to be the hottest topic of the upcoming Presidential elections. As an agency with tens of thousands of Medicare supplement policyholders, we get lots of questions, like “What is Medicare for All and how would it work?” There are actually a number of healthcare reform proposals that use Medicare in the name of the legislation and several presidential contenders have named their legislation specifically Medicare for All. However, let me be clear about one thing: NONE of these proposals are anything like our current Medicare system. blue cross medicare advantage plan as it stands today – right now in 2019 – is a beloved national program that works beautifully to provide affordable coverage for tens of millions of America. It is not a single-payer system, but does have a considerable amount of federal management, rules and regulations. The Medicare for All proposals below should really not have the word “Medicare” in them at all because it is misleading. These programs would not extend the current Medicare system to everyone. They would replace it with something very different and everyone currently on Medicare would lose the coverage they have today. Let’s look at the facts of these single-payer proposals: Medicare for All under Bernie Sanders (I-VA): S. 1129Bernie Sanders was the first to name give his proposal for healthcare reform the moniker of Medicare for All. He believes healthcare should be a human right and that the only way to ensure coverage for everyone is to offer universal coverage in the U.S. The bill establishes a national health insurance program that would be administered by the Department of Health and Human Services.x Bernie’s single-payer plan would cover all United States residents, and individuals would qualify for automatic enrollment upon birth or residency. The federal government would run the program and replace nearly all existing public and private healthcare plans. Some federal programs would continue, such as the Veterans Health Administration and Indian Health Service. This plan would cover all essential medical treatment including hospital and outpatient services, prescription drugs, mental health and substance abuse treatment, dental and vision services, and home- and community-based long-term care. This means it would cover considerably more than the current Medicare program we have in place today. Medicare, as it stands now, does not cover dental, vision, and hearing services, or long-term-care expenses. In Bernie’s ideal Medicare for All program, everyone gets free healthcare. There would be no premiums, copays, deductibles, or coinsurance for covered services except for prescription drugs. It would also ban private health insurers and allow employers to offer only coverage that is supplemental to Medicare and not duplicative of any of the benefits provided under the program. Medicare for All would free Americans from employer health coverage that may often prevent them from switching jobs. The secretary would establish the national drug formulary and would negotiate drug costs annually with the pharmaceutical manufacturers. Bernie’s proposal would allow for a 4-year transition from today’s healthcare into the new regime. It has 14 original co-sponsors. What Would Medicare for All Cost It is estimated the program would cost the United States about $3.5 trillion dollars, which would represent a 2% increase in total healthcare spending today. However, the sources of that coverage would shift from private insurance companies over to the federal government. This, of course, draws a lot of criticism as the politicians who are backing universal coverage are sometimes vague on how they propose to pay for this plan. Some of the options to fund the program that have been discussed are: A Premium Paid by Employers and Broader Self Employment TaxWe would impose a 7.5% income-based premium paid by employers. It would exempt the first $2 million in payroll to protect small businesses. Sanders’ plan would make business owners report more of their company’s income as salaries so that they would pay more self-employment taxes. A Premium Paid by All Employees Making More Than $29,000 The legislation could create a 4% income-based premium paid by employees. It would exempt the first $29,000 in income for a family of four. Eliminate Health Tax Expenditures for Businesses Since Bernie’s Medicare for All would bank employer-based health insurance, it would also get rid of employer’s deductions for the healthcare insurance they currently provide. This leaves more available dollars that can be taxed by the federal government to pay for Medicare for All. It would also eliminate Health Savings Accounts and medical expense deductions for families. A More Progressive Federal Income TaxOne proposal is to implement a marginal tax rate that goes up to 70% for those making more than $10 Million. It would also tax earned and unearned income (such as capital gains and dividends) at the same rates and limit the tax deductions available for filers who are in the very top tax bracket. If Medicare for All is passed with this funding option, the United States would have the highest income tax rate in the entire world. A More Progressive Estate TaxThis option would increase the top tax rate on inheritances, including a death tax rate of 77% for those with more than $1 billion, essentially preventing the wealthiest of families from passing on most that wealth to their heirs. A Wealth Tax In addition to the more progressive income tax, Bernie’s plan would establish an additional wealth tax on people in the top 0.1% of earnings. Collect Fees on Large Financial Institutions The law could create and collect additional fees for banks and other large financial institutions. This move is estimated to collect over $800 billion across a ten-year period. Medicare for All under Elizabeth Warren’s Medicare for All program would go one better than Bernie’s plan in that it would provide healthcare to absolutely everyone, including illegal immigrants. How Elizabeth Warren Would Pay for Medicare for All Warren claims her funding plan would not increase any middle-income class taxes, although Bernie disagrees. Her plan calls for various savings by way of reducing spending, such as redirecting taxpayer-funded health spending, stemming the growth of medical costs, reining in prescription drug costs, minimizing defense spending, and reducing insurer administrative costs. Raise Taxes on the Largest Corporations Currently, companies can deduct the cost of certain types of investments that they make into assets that \depreciate. Warren’s plan would slow the schedule of that depreciation. Tax the Top Financial Institutions Implement a fee that would apply to roughly the top 40 banks in the nation to collect an additional $100 billion over 10 years. Tax Financial Transactions Warren would also create a tax on financial transactions such as the sale of stocks and bonds to generate about $800 billion for the Medicare for All program Raise Taxes on the Top 1%Warren’s plan would include a wealth tax of 6% on people with more than $1 billion. Redirect Current Medicare/Medicaid Spending Warren claims that some of the financing for Medicare for All would come from using existing federal spending that is spent on the current Medicare and Medicaid programs.
0 Comments
Leave a Reply. |
Author
Archives
January 2020
|