Congressional Democrats have released another Medicare reform bill. Although the Medicare for America Act of 2018 was introduced last year, it’s gaining more attention now that it’s been endorsed by Democratic presidential candidate Beto O’Rourke.
About the bill
Sometimes called M4Am or MFA, Medicare for America was introduced at the end of 2018 by Representatives Rosa DeLauro (D-CT) and Jan Schakowsky (D-IL). The bill was founded on the work of Jacob Hacker, a Yale professor working with the Center for American Progress.
Hacker said in an interview, “I think it makes sense to go slowly in moving people into Medicare to minimize backlash among those who depend on it already. Disruption is one of the big reasons why an immediate move to a single-payer system is probably a bridge too far in American politics for the foreseeable future.”
The following Americans would be covered by this bill:
- The uninsured
- People covered by Obamacare marketplace plans
- Medicaid beneficiaries
- Seniors who already receive Original Medicare coverage
In addition to covering all of the medical items and services already covered by Medicare, Medicare for America would also cover:
- Prescription drugs
- Dental, vision, and hearing services
- Long-term healthcare
- Family caregiver compensation
This bill would also allow working Americans to keep their employer-sponsored health plan. Under this bill, employers could:
- Offer private insurance plans, as long as they pay at least 80 percent of healthcare costs,
- Provide employees with Medicare coverage and pay a contribution toward their employees’ costs, or
- Allow employees to opt out of private plans and enroll in Medicare coverage.
One aspect of this bill that sets it apart from other Medicare reform bills is that all out-of-pocket costs would be set on an income-based sliding scale.
- Premiums. Those living below 200 percent of the federal poverty line (FPL) would have premium-free coverage under this plan. In 2019, the FPL is $12,490 for an individual and $25,750 for a family of four. Americans living with incomes between 200 and 600 percent of the FPL would pay premiums based on a sliding scale.
- Deductibles. Deductibles would be capped at $350 for individuals and $500 for families.
- Out-of-pocket costs. Out-of-pocket costs would be capped at $3,500 for individuals and $5,000 for families.
How would Medicare for America be funded?
According to the bill, Medicare for America would be funded in five different ways, by:
- Rolling back the Republican tax cuts for corporations,
- Adding a 5 percent tax on incomes exceeding $500,000,
- Increasing Medicare payroll taxes,
- Adding an excise tax on tobacco, alcohol and sugary drinks, and
- Requiring states to continue contributing what they currently pay for Medicaid costs.
The Democratic Medicare divide
His endorsement of this bill sets Beto O’Rourke apart from the crowd of Democratic presidential hopefuls, almost all of whom have co-signed Bernie Sanders’s Medicare for All bill. O’Rourke previously supported a single-payer system, but recently reversed his position, saying he’s opting for a more pragmatic approach.
Beto O’Rourke will face off against the following candidates in the first round of Democratic primary debates Wednesday, June 26 8/7c: Booker, de Blasio, Castro, Delaney, Gabbard, Inslee, Klobuchar, Ryan, and Warren.
The second debate will be held Thursday, June 27 at 8/7c and feature Biden, Bennet, Buttigieg, Gillibrand, Harris, Hickenlooper, Sanders, Swalwell, Williamson, and Yang.