Medicare for All: a Pathway to Universal Health Coverage?

Medicare for All: a Pathway to Universal Health Coverage?

By Alex Graf for The Globe Post

Even hours before the House Ways and Means Committee considered several proposals during its June 12 hearing on “pathways to universal health coverage,” it was apparent that Medicare for All would be the star of the show. It was the first time in U.S. history that Medicare for All would be heard before the committee, and activists supporting the bill were ready to flex their grassroots muscle.

Dozens of Medicare for All advocates from organizations such as Our Revolution and National Nurses United lined the hall outside the hearing room, passing out Medicare for All T-shirts and tote bags to fellow attendees. By the time proceedings began, every seat in the room was filled with onlookers, including Representative Pramila Jayapal of Washington, the lead sponsor of the House Medicare for All legislation. If there was grassroots support behind any of the other proposals under consideration, it was nowhere to be seen in the hearing room.

Unlike most other developed nations, the United States does not guarantee healthcare as a right to all of its residents. Instead, the U.S. healthcare system is an amalgamation of several types of health coverage, including government plans like Medicare, which covers people age 65 and up and private health insurance which is usually offered through employers.

The U.S. spends around twice as much per person on healthcare compared to other developed countries, but this doesn’t translate to a higher quality of care. Almost 30 million Americans remain without health insurance and the U.S. healthcare system underperforms relative to other countries by most metrics. In the U.S. over 500,000 families file for bankruptcy every year due to illness or medical bills, according to a study from the American Journal of Public Health.

Medicare for All supporter with a sign
Jackie Macmillan holds up her Medicare for All sign outside the Longworth House Office Building where the House Ways and Means Committee held their hearing on “pathways to universal health coverage.” Photo: Alex Graf

“What I’ve heard on the road is that we’ve had enough of incrementalism,” National Director of Our Revolution Joseph Geevarghese told The Globe Post.

“We need systemic, transformational change. People don’t want just tweaks here and there. They fundamentally believe the system as it is currently is not working for them. There is a lot of anger around healthcare cost and prescription drugs. I think they’ve had enough. That’s my vibe.”

The hearing on pathways to universal health coverage was part of an effort by House Democrats to expand access to healthcare. The committee considered five different healthcare proposals that would do so to varying extents. Medicare for All and Medicare for America were the two most ambitious proposals. Both plans would establish a government-funded health insurance program, but the main difference between the two is Medicare for All would eliminate the role of private insurance with few exceptions, while Medicare for America would leave the door open for Americans to keep their current private plan.

Other plans would lower Medicare’s age of eligibility from 65 to 50, introduce a public insurance option, or give states the choice to establish a buy-in to Medicaid, which offers health insurance to poor Americans.

While Republicans on the committee formed a united front in opposition to any of the proposals under consideration, and Medicare for All especially, Democrats on the committee appeared less cohesive in their stances. Some, like Representative Earl Blumenauer of Oregon and Representative Jimmy Gomez of California expressed their full-throated support of Medicare for All. Others like Committee Chairman Richard Neal were noncommittal, instead opting not to take a strong stance on any one of the proposals under consideration.

As the hearing began, Neal, who reportedly asked his colleagues to refrain from using the term “Medicare for All” during the hearing, gave an opening statement.

“What unites us as Democrats is our shared core belief that all Americans should have health care coverage and receive care that is not a financial burden,” Neal said.

The ranking member of the committee, Republican Kevin Brady of Texas followed up with an opening statement of his own.

“When you pull the curtain back on Medicare for All, the truth is staring at you,” Brady said. “Many Americans will pay more, wait longer for healthcare and receive worse care than you receive now.”

In the first ever #MedicareForAll hearing in the Ways & Means Committee!

Btw–it was amazing to listen to GOP ranking member’s opening statement. Not a SINGLE thing was true.

Don’t forget, GOP has done everything they can to strip Healthcare away.

— Rep. Pramila Jayapal (@RepJayapal) June 12, 2019

The Committee then heard testimony from several witnesses including representatives from the Kaiser Family Foundation, the Institute for Healthcare Improvement and the Washington Health Benefit Exchange. Also providing testimony was Medicare for All advocate and mother Rebecca Wood, whose daughter, Charlie, struggled with medical complications due to her premature birth.

“Co-pays, deductibles, automatic denials, and exclusions drained our savings and financially devastated us over time,” Wood said.  “In addition, I had to, and have to, make impossible choices. Do I pay for her therapy or my overpriced asthma medication? Choices like these really aren’t impossible. I choose to pay for hers and go without mine.”

Wood described one instance where she was forced to delay a dental procedure in order to continue paying for her daughter’s therapy; a decision she said cost her “dearly.” The delay allowed an infection to spread throughout Wood’s mouth and jaw, obstructing her breathing.  

“I had all of my teeth pulled, the infection drained, and parts of my jaw scraped away in a six-hour procedure under local anesthesia. I could not afford to have it done under general anesthesia,” Wood said.

Must watch story of Rebecca Wood and her daughter #MedicareForAll pic.twitter.com/8QAowRgdAl

— People for Bernie (@People4Bernie) September 13, 2017

Republicans repeatedly called on Grace-Marie Turner, the president of the conservative Galen Institute, for testimony.

“Today Medicare for All is center stage,” Turner said. “It would mean virtually everyone would lose the plans they have now and there would be no choice but the one government-run plan.”

After hours of hearing testimony and questioning witnesses, several Democratic members of the Ways and Means Committee who cosponsor Jayapal’s Medicare for All bill stepped outside to the House Triangle for a press conference with the bill’s lead sponsor. Jayapal thanked the various grassroots organizations in attendance and touted the 113 cosponsors currently signed on to her legislation as well as a letter from over 200 economists in support of the bill.

“Today for the first time in the history of the House of Representatives, we are having a hearing on Medicare for All in the Ways and Means Committee,” Jayapal said.

As he took the podium, Blumenauer said the hearing gives Americans the opportunity to “delve into the facts” about the U.S. healthcare system and consider single-payer health care as a real possibility.

“This is an imperative and this is what the public wants,” Blumenauer said. “It’s not going to happen overnight, but we’re on a path to universal healthcare and brushing aside the lame excuses some of my Republican friends started to trot out.”

After several Medicare for All Cosponsors took their turns speaking, Jayapal answered one question from The Globe Post before heading back to the capital building for votes. Jayapal said her Medicare for All bill offers a comprehensive set of benefits that “does not currently exist.”

“Today if you want to get mental health, vision, or dental you have to buy separate coverage even if you’re already covered by Medicare,” Jayapal said. “This is an expanded and improved Medicare for All…a lot of that care is being covered by private insurers who charge a lot of money…we have incorporated those benefits into Medicare for All. We have said that if you’re a private insurance company, you cannot offer the same benefit, so it is going to limit the role of private insurance companies.”

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