4 Proposed Medicare for All Alternatives
4 Proposed Medicare for All Alternatives could be the beginning of universal healthcare. By now you’ve probably heard of Bernie Sanders’ (D-VT) “Medicare for All,” a proposal to create a public health insurance program that’s free for everyone. Well, that’s not the only legislation that would expand the current Medicare program.
Democrats in Congress have introduced several other bills that would make more people eligible for Medicare while keeping some elements of our current healthcare system.
The proposals should fix the growing problem of healthcare affordability. Insurance premiums and out of pocket costs paid by Americans and their employers are rising faster than wages or inflation.
Some people cannot afford health insurance at all, or they end up in high deductible health plans with expensive out of pocket costs. When healthcare costs too much, people don’t get treatment for illnesses, injuries, and chronic conditions.
Here’s a quick look at five of those proposals.
Proposed Medicare for All Alternatives: Medicare at 50
Implementing Medicare at 50 would allow people aged 50-64 to buy Medicare coverage. Currently, Medicare is only available to people who are aged 65 and older or some individuals on disability.
The legislation would allow people to use their Affordable Care Act subsidies toward traditional Medicare or a Medicare Advantage plan.
Medicare at 50 is for people who face the highest premiums under the Affordable Care Act: those who are nearing retirement age. The idea is that Medicare coverage costs less than a typical ACA plan, helping this age group retain access to health care.
Sponsors of the legislation hope it’s more acceptable to Republicans than Sanders’ plan; since it’s a smaller expansion of Medicare and not a sweeping change to the whole healthcare system.
However, it’s still up against strong opposition. Especially from hospital groups who say they won’t stay profitable if Medicare expands.
Their reason is Medicare’s reimbursement rates are much lower than the rates paid by private insurance companies.
Medicare for America
Enacting Medicare for America means replacing the current healthcare system; including Medicare, Medicaid, and the Affordable Care Act marketplace. This would be a universal healthcare system that would cover everyone.
Unlike Medicare for All, Medicare for America would not be free. Most people would pay a premium, and premiums would be higher for people with higher incomes.
However, premiums would be capped at 9.69 percent of monthly income.
Employers could continue to offer health insurance to their employees, or they could pay a premium to have employees covered by Medicare for America.
Employees who qualify for an employer plan could choose to enroll in that plan or in Medicare for America. The program would also include a private Medicare Advantage for America option.
Proposed Medicare for All Alternatives: Medicare X
The idea behind Medicare X is to use an expansion of Medicare to create competition in the health insurance marketplace. Medicare would be offered as an option for people who buy insurance on the health insurance exchange.
Medicare X would be available starting in 2021 in rural areas where people tend to have the fewest health insurance choices. It would expand nationwide by 2024.
Medicare X would offer subsidies based on income. Premiums would be capped at 13 percent of income.
By giving people the chance to buy into lower-cost Medicare policies. Medicare X has the potential to make better health care possible for people under 65 and unable to afford the options currently available under the Affordable Care Act.
The Keeping Health Insurance Affordable Act of 2019
This legislation would add a public health insurance option for people who are eligible to buy individual insurance on the ACA exchange. It would use the existing ACA structure but expand premium subsidies.
This legislation introduces a new public health insurance option without disrupting the current structure of our healthcare system.
The Choose Medicare Act
Of the 4 proposed Medicare for All alternatives, the Choose Medicare Act also adds a public health insurance option (known as Medicare Part E) to the roster of choices for people enrolling in ACA marketplace plans.
Employers could also offer Medicare Part E to their employees. The Choose Medicare Act would also expand subsidies that help people with lower incomes pay for premiums.
These bills are early attempts to confront a problem that concerns all of us: the exponential rise in healthcare costs.
When people cannot afford to go to the doctor, they become sicker, and an unhealthy population takes a toll on individuals, their families, and our society.
Undoubtedly, these proposals are subject to rigorous debate and fierce opposition. However, they’re a hopeful sign that healthcare may one day become more affordable, and not just for people who are over 65 or on disability.