Sen. Bernie Sanders has released the new version of his Medicare for All bill.
The Vermont independent has been introducing Medicare for All bills for years, and he is continuing to seek a broad transformation of the U.S. health care finance system.
If Sanders’ “Medicare for All Act of 2019″ bill were adopted and implemented as written, and worked as Sanders expects, it would replace all commercial major medical insurance, Medicaid, Medicare, dental insurance, vision insurance, short-term care insurance and long-term care insurance with a government-run health plan that would be much richer than most European single-payer health care systems, with a maximum of $200 per year in cost-sharing.
(Related: How Might ‘Berniecare’ Work?)
Sanders has also proposed that, during a three-year period, ordinary commercial health insurance, Medicare Advantage plans and Medicare supplement insurance would still exist.
When Donald Trump became president, he and his appointees suddenly became responsible for managing health insurance under the framework Barack Obama and other former presidents had created.
Sanders’ transitional period coverage rules raise the question: What might Bernie Sanders’ (or other Medicare for All advocates’) version of the current Trumpcare framework look like?
Here are some possibilities, drawn from Sanders’ new proposal.
1. Consumers could sign up for traditional Medicare earlier.
Title X of the Sanders bill would create a transitional Medicare buy-in option.
Sanders would lower the buy-in eligibility age to 55 effective Jan. 1 of the first year following the date of enactment; 45 effective Jan. 1 of the second year after enactment; and 35 effective Jan. 1 of the third year after enactment.
A consumer who was eligible for the early Medicare buy-in program could choose between signing up for traditional Medicare coverage or for signing up for Medicare Advantage plans with prescription drug coverage.
Sanders would classify Medicare coverage as minimum essential coverage, or solid major medical coverage, for purposes of applying the Affordable Care Act (ACA) individual shared responsibility penalty.
Consumers could use ACA premium tax credit subsidies to pay for the Medicare buy-in coverage.
2. Sanders would, briefly, let officials at the U.S. Department of Health and Human Services (HHS) talk to people at health insurance companies.
Sanders mentions workers’ compensation carriers briefly.
He refers private health insurers only a few times.
He talks about private health insurers once in connection with efforts to set up the transitional Medicare buy-in program.