You have no doubt heard Bernie Sanders has introduced the Medicare for All Act of 2017 in the Senate today, along with sixteen other cosponsors from the Democratic Conference in the US Senate. But do you know what is in it? If you would like to read the entire text for yourselves, you are welcome to do it here. If you would rather just settle for the bullet points, we will do our best to summarize them below:
WHO IS COVERED
Every “resident” of the United States, which includes US citizens as well as non citizens. Whether those will include only documented or documented as well as undocumented immigrants will depend on how the Health and Human Services Secretary defines the term “resident” which this law provides. Likely, it will vary by Administration. Eligible residents shall be issued a Universal Medicare Card. Additionally, plastic surgery which is non-reconstructive in nature (i.e. cosmetic)
WHAT IS (NOT) COVERED
Essentially, all emergency, clinical, diagnostic and preventative health care, dental care and vision benefits. Long term care (convalescent homes, nursing care, assisted living, etc.) are not covered by this bill, but would be under separate legislation as part of Medicaid, which would presumably continue to exist to among other things, pay for the Medicare premiums of those who qualify. States can decide to cover additional services (or people) at their own expense.
COSTS AND PAYMENTS
Zero deductibles and zero co-pays to patients on every service except brand name prescription drugs, which will have a co-pay of $200 per year, adjusted for inflation. Providers will be paid in accordance with a Fee Schedule just like they are presently.
CHOICE OF DOCTORS
Anyone can go see any health provider in the United States who accepts Medicare. (presently 72% of all physicians practicing in the US do, a number which will no doubt grow once more patients carry the insurance)
Enables the government to negotiate with pharmaceutical manufacturers for bulk pricing to create cost control.
In year one of passage, residents who are under the age of 19 and age 55 to 65 will be eligible to enroll, as well as those declared by the Social Security Administration to be disabled. The current 24 hour waiting period for people with disabilities to enroll into Medicare is to be eliminated. In year two of passage, eligible residents ages 45 to 55 will be enrolled. In year three, residents ages 35 to 45 will be able to enroll, and in year four, everyone will be enrolled. During the transition period, those not eligible to enroll will be able to buy into Medicare the same way they can purchase private insurance.
While everyone will lose their premiums or deductibles, there will be additional taxes. Although this particular bill doesn’t specify them, Bernie’s team during the campaign outlined the following revenue plan:
- Every working individual will have a 2.2% increase on his or her income tax. The vast majority of people will save money since they spend more than 2.2% of their paycheck on health insurance premiums which have deductibles and co-pays.
- Employers will lose the Obamacare mandate to provide coverage to their employees, but will pay 6.2% of their profits towards covering the costs of the plan.
- Higher earning individuals will have their present top income tax rate hiked as follows:
- For income between $250K and $500K, taxes will go up from a top bracket of roughly 35% (an average of multiple brackets) to 37%
- For income between $500K and $2 Million, taxes will go up from 39.6% to 43%
- For income between $2 Million and $10 Million, taxes will go up from 39.6% to 48%
- For income above $10 million taxes will go up from 39.6% to 52%
- Investment (aka capital gains) income will no longer be taxed at lower tax levels than ordinary income, but at the same, making the investor class on the same level as paycheck earners.
- Limitations of tax deductions on earners making above $250,000.
- Imposing the Estate Tax from $11 Million to $3.5 Million (meaning that those who receive an inheritance higher than $3.5 million would have to pay an estate tax, as opposed to now where they must receive above $11 million before they are taxed. Those who receive an inheritance lower than $3.5 Million will continue to be tax free.)