Health Reform WK-EDGE House committee hears arguments for universal health care coverage
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Wednesday, June 26, 2019

House committee hears arguments for universal health care coverage

By Cathleen Calhoun, J.D.

Advocates of universal health care coverage are arguing for different programs, but which one is the best or do the current proposals cost too much?

Health care should be expanded, through Medicare for All, or another proposed plan, most witnesses urged at the House Ways and Means Committee hearing titled, "Pathways to Universal Health Coverage." The purpose of the hearing was to explore opportunities to achieve affordable universal coverage.

Three main proposals were discussed at the hearing:

  • Medicare for All
  • Medicare for America
  • Medicare/Medicaid buy-in

Medicare for All. Medicare for All would create a government-funded health insurance program and, with some exceptions, eliminate the role of private insurance. Medicare-for-all is the most ambitious of the proposals—replacing all current forms of public and private health insurance with a new federal program that would guarantee health coverage for all U.S. residents regardless of age, according to testimony by Tricia Neuman, Sc.D.Senior Vice President and Director, Program on Medicare Policy at The Kaiser Family Foundation.

Donald Berwick, Senior Fellow at the Institute for Healthcare Improvement and former Administrator of the Centers for Medicare and Medicaid Services (July 2010 - December 2011), stated, "a wise choice for this nation would be Medicare for All." He argued that a universal Medicare for All program could help advance health equity through providing support to physicians and hospitals serving vulnerable or impoverished patients.

While at the same time stating that everyone should be able to get health coverage to access the health care they need, Grace-Marie Turner, President of the Galen Institute, added that, "Americans want more, not fewer choices in health coverage, and Medicare for All would put them all on a single government program." She added that looking globally at other countries, and analyzing consequences, single payer systems would:

  • disadvantage the most vulnerable
  • result in provider shortages
  • disrupt current coverage
  • lead to increased government spending

Medicare for America. The Medicare for America Proposal, introduced by Representatives DeLauro and Schakowsky, would expand Medicare to all people covered by Medicaid and the ACA. Medicare for America would maintain premium contributions and some parts of the current insurance system, creating a Medicare Advantage-type option, while preserving the employer-sponsored insurance market and allowing people to keep their employer-based coverage if they choose, according to Chiquita Brooks-LaSure, Managing Director at Manatt Health Strategies, LLC.

Medicare/Medicaid buy-in. Brooks-LaSure also explained the Medicare/Medicaid buy-in proposal. Under a Medicare/Medicaid buy-in, the federal government would allow consumers who are ineligible for Medicare to purchase Medicare coverage. A Medicare buy-in for Americans over 50 years old would increase coverage options for a population in immediate need of assistance, without much disruption to current markets and government programs.

Companies: The Kaiser Family Foundation; Manatt Health Strategies, LLC; The Galen Institute; Company; Institute for Healthcare Improvement

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