Senator Kamala Harris is releasing her plan for Medicare for All, laying out how best to get to universal coverage in a system where cost is not a barrier for people to get health care. The plan expands the Medicare system to give everyone access to comprehensive health care. Medicare for All will cover all medically necessary services, including emergency room visits, doctor visits, vision, dental, hearing aids, mental health and substance use disorder treatment, and comprehensive reproductive health care services. It will also allow the Secretary of Health and Human Services to negotiate for lower prescription drug prices.
“Right now, the American health care system is a patchwork of plans, providers and costs that have left people frustrated, powerless and insurance companies in charge. And the bottom line is that health care just costs too much,” Harris writes in a new Medium post today. “We need comprehensive health insurance that covers every American.”
Here’s how her plan works:
•First, all Americans will immediately have the ability to buy into Medicare. This is similar to the immediate, introductory buy-in provided in Senator Sanders’ Medicare for All bill.
•Second, it establishes an expanded Medicare system, with a 10-year phase-in period. During this transition, newborns and the uninsured will automatically be enrolled into this public Medicare plan. The extended phase-in period gives all doctors time to get into the system and provides a commonsense path for employers, employees, the underinsured, and others on federally-designated programs, such as Medicaid or the Affordable Care Act exchanges, to transition. Expanding the transition window will also lower the overall cost of the program.
•Third, the plan allows private insurers to offer Medicare plans as a part of this system that adhere to strict Medicare requirements on costs and benefits. This would function similar to how private Medicare plans work today, which cover about a third of Medicare seniors, and operate within the Medicare system.
“This plan builds on the progress we made in the Affordable Care Act and expands upon its promise of universal coverage through a sensible expansion of the popular Medicare system,” said Kathleen Sebelius, the former Secretary of Health and Human Services in the Obama administration, who helped architect the Affordable Care Act. “To get all Americans covered by health insurance, where cost is not a barrier, we need innovative ideas like this. Senator Harris’ plan is a smart way to get to Medicare for All where all individuals and employers can transition smoothly into a system that covers everyone.”
“This is exactly the right approach to reduce health care costs and ensure our country smoothly transitions to universal health care,” said Kavita Patel, a Brookings fellow and former Obama White House health care policy advisor. “Senator Harris’ plan builds on our successful Medicare system by expanding benefits and dramatically curbing the power of insurance companies, all while providing comprehensive care that is currently missing from many health plans; services like dental care, hearing aids and long term care. Harris’ vision of Medicare for All is achievable, clear, and demonstrates a firm commitment to making access to health care a right for all Americans, regardless of income.”
“Senator Harris’s plan balances idealism and pragmatism,” said Andy Slavitt, who ran the Medicare, Medicaid and the ACA for the Obama administration. “It says in effect: we have a mandate to get everyone affordable health care and put people over profits— but we don’t need to tear down the things people have and they like in order to do it.”
“The Harris plan is a carefully designed transition to Medicare for All,” said health care expert Topher Spiro. “It guarantees universal coverage in the short term while allowing families to move over to the Medicare plan at their own pace.”
“Senator Harris is outlining clear, serious and thoughtful proposals to finance her approach to Medicare for All,” said tax and economic policy expert Michael Linden. “Her plans to ensure that Wall Street and multinational corporations are paying their fair share of taxes are both good ideas, and would generate enough revenue to offset her proposal’s higher income threshold after which premium payments begin—$100,000 rather than $29,000—which is intended to help the middle class.”
To pay for this plan, Harris has pointed to a number of good ideas — from an income based premium paid by employers, to higher taxes on the top one percent and taxing capital gains at the same rate as ordinary income, among others. One idea put forward by Senator Sanders, for example, is increasing taxes for families making as little as $29,000 a year. She believes that hits the middle class too hard, so she would not raise taxes on families making under $100,000 to help pay for this plan.
To pay for this specific commitment, she would impose a new Wall Street trade tax — taxing stock trades at 0.2%, bond trades at 0.1%, and derivative transactions at 0.002% — and end foreign tax shelters by taxing offshore corporate income at the same rate as domestic corporate income. Together, these proposals would raise well over $2 trillion over ten years, more than enough to make up the difference from raising the middle class income threshold.
“I look at this issue through a fairly simple prism: each night, millions of Americans wake up at 3 o’clock in the morning worried about some aspect of their health care,” Harris continued on Medium. “How am I going to afford a $5,000 deductible just for walking my child into the emergency room because their fever won’t go down? How will I pay that surprise medical bill because the ambulance that took me to the hospital was out-of-network? How am I going to continue to see my doctor when I get a new job and my new insurance plan doesn’t have them in their network?”
“This isn’t about pursuing an ideology,” Harris said. “This is about delivering for the American people. Health care is personal to people and we should make sure we get it right.”