Sanders unveils single-payer healthcare bill

Sen. Bernie Sanders on Wednesday unveiled legislation that would dramatically reshape the American healthcare system into one where most people get their insurance from a single government-run health plan instead of the private health insurance market.

Sanders' bill, the Medicare for All Act of 2017, is co-sponsored by 16 Democratic senators. It proposes to move the country toward a single-payer healthcare system, which Sanders said would expand comprehensive coverage to every family and reduce the nation's healthcare spending. The single-payer concept was the cornerstone of Sanders' 2016 presidential campaign.

The bill was introduced the same day four Republican senators unveiled a proposal to repeal and replace the Affordable Care Act by giving states $1.2 trillion in subsidies and letting them design their own coverage systems with few limitations.

The Medicare for All bill would establish a national health insurance program called the Universal Medicare Program. The expanded Medicare program would cover services including hospital and ambulatory care, primary care, preventive services, mental health and substance abuse services, and prescription drug costs. It would also cover reproductive, maternity and newborn care, as well as abortions.

Premiums, copayments and deductibles paid to private health insurance companies would be eliminated. Employers, Sanders said, would be free to run their businesses without worrying about providing health coverage to employees. Patients would be able to choose their doctors and hospitals without considering if the provider is in their network.

The transition to the program would occur over four years. In the first year, the eligibility age to enroll in Medicare would be lowered to 55. Benefits for seniors would expand to include dental care, vision coverage and hearing aids. Additionally, all children under the age of 18 would be covered. The eligibility age would be lowered to 45 in the second year and 35 in the third year. By the fourth year, all individuals would be covered by the program.

Sanders, an independent from Vermont, also said that under the Medicare for All system, the government would negotiate with pharmaceutical companies to lower prescription drug costs.

Important questions remain about the price tag and how the program would be funded. The Urban Institute think tank last year estimated that a previous version of Sanders' plan released during his presidential campaign would have increased federal spending by $32 trillion over 10 years.

Sanders said Americans would ultimately pay less for healthcare. "Under Medicare for All, 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," he said during an event in Washington on Wednesday to introduce the legislation. "While, depending on your income, your taxes may go up to pay for this publicly funded program, that expense will be more than offset by the money you are saving by the elimination of private insurance costs."

The co-sponsors of the bill include Sens. Tammy Baldwin (D-Wis.), Richard Blumenthal (D-Conn.), Cory Booker (D-N.J.), Al Franken (D-Minn.), Kirsten Gillibrand (D-N.Y.), Kamala Harris (D-Calif.), Martin Heinrich (D-N.M.), Mazie Hirono (D-Hawaii), Patrick Leahy (D-Vt.), Edward Markey (D-Mass.), Jeff Merkley (D-Ore.), Brian Schatz (D-Hawaii), Jeanne Shaheen (D-N.H.), Tom Udall (D-N.M.), Elizabeth Warren (D-Mass.) and Sheldon Whitehouse (D-R.I.).

The legislation is largely symbolic and is meant to drum up public support for a single-payer system. Its introduction faces a steep uphill battle, and Sanders and his supporters acknowledge it will be easily defeated in the Republican-controlled Congress.

"Our opponents on this issue have the money, and they have the power," Sanders said Wednesday. "But if millions of people across this country stand up and get involved in the political process and fight back, I have no doubt, none whatsoever, that this nation sooner than people believe will in fact pass a Medicare-for-all single-payer system."

The bill will face fierce opposition from private health insurers, hospitals and pharmaceutical companies. Early Wednesday, ahead of the introduction of Sanders' bill, the insurance industry's lobbying group, America's Health Insurance Plans, came out swinging against single-payer proposals, while acknowledging it didn't have any of the bills' specifics.

In a statement, AHIP Executive Vice President David Merritt stressed the importance of building on "proven" private market solutions to handle rising healthcare costs, and urged against adopting "theoretical, one-size-fits-all approaches."

"Whether it's called single-payer or Medicare for All, government-controlled healthcare cannot work," Merritt said. "It will eliminate choice, undermine quality, put a chill on medical innovation and place an even heavier burden on hardworking taxpayers.

At the same time, supporters of Medicare for All point out that the concept of a single-payer system—once a fringe issue—is gaining steam in the wake of Republicans' failed attempts to dismantle the Affordable Care Act.

"What we've seen coming out of the Affordable Care Act fight is a real grass-roots movement expressing both peoples' fury with the existing heath system and its inadequacy and how it affects them personally, but also a real widespread public demand for a system that operates by a different value system, one where we all take care of each other and where healthcare is a right," argued Robert Weismann, president of Public Citizen, a not-for-profit consumer advocacy organization, which held a discussion Tuesday on the merits of single-payer.

Congressional support for single-payer is growing. More than 60% of House Democrats, or 117 cosponsors, have endorsed a Medicare-for-all bill introduced in January by Rep. John Conyers Jr. (D-Mich.)

A little more than half of the public said they now favor a single-payer healthcare, while 43% said they opposed it, a recent Kaiser Family Foundation poll found. The poll of 1,208 U.S. adults over age 18 was conducted by phone in June.