After successfully leveraging promises for far-left policy reforms into a competitive challenge against frontrunner Hillary Clinton during the 2016 Democratic primary (forcing Debbie Wasserman Schultz to intervene on her longtime friend's behalf), Senator Bernie Sanders has finally introduced a long-anticipated piece of legislation: His bill to create a single-payer health-care system, or, as his supporters know it best, “Medicare for all.”
As expected, the proposal would offer the same suite of medical benefits required for some insurance plans under the Affordable Care Act and eliminate most out-of-pocket costs. Mr. Sanders argues that although taxes would likely rise to support the new system, families would save money by no longer needing to purchase health coverage, according to the Wall Street Journal.
Unsurprisingly given Sanders’s well-known views on government spending, the 96-page bill offers no mechanisms to pay for the plan, which is expected to cost the federal government hundreds of billions of dollars a year. A Bernie spokesman said his office plans to release a separate white paper focusing on payment strategies, but as of now, no such plan exists.
While the bill’s chances of passing are infinitesimal (Republicans remain vehemently opposed), as the WSJ explains, the symbolism surrounding its introduction is actually quite potent.
As the Democratic party shifts further to the left, socialized medicine (Like they have in Canada!) is becoming a rallying cry for the party. Already, four of the top-polling contenders for the 2020 presidential nod have signed on to the plan.
“A health-care system as Mr. Sanders envisions it remains unlikely with Republicans in control of the White House and both chambers of Congress. But the idea has caught on with many Democrats since Mr. Sanders touted it on the 2016 presidential campaign trail; when he debuted a similar plan in 2013, none of his Democratic colleagues signed on.
Single-payer health care is becoming a rallying cry for many Democrats much as the seven-year promise to “repeal and replace” the ACA brought together Republicans.
At least four potential 2020 Democratic presidential contenders, Elizabeth Warren of Massachusetts, Kirsten Gillibrand of New York, Kamala Harris of California and Cory Booker of New Jersey, have all signed onto the plan.”
In a timeline chronicling the Democratic Party’s flirtations with single payer, the International Business Times explains how the idea of universal health-care coverage was first proposed by former President Harry Truman in 1945. After Democrats successfully created the Medicare and Medicaid programs during the 1960s, some progressive hoped to follow by extending coverage to all citizens. The idea slowly lost favor during the 1970s and 1980s, as Ronald Reagan criticized what he saw as “socialized medicine.”
But it was revived in 1992 when California’s once-and-future governor Jerry Brown campaigned on it during the Democratic primary. He was defeated by Bill Clinton who decided to institute reforms that preserved the existing private-insurance system after failing to muster support for “Hillarycare” – the Clintonian plan for a single-payer system.
Moving ahead to the Obama era, the former president famously flip-flopped on the issue, saying he “never supported single payer” even though there were records of him speaking favorably about the policy dating back to 2003, when he was a state senator in Illinois.
During the formulation of what would become Obamacare, some Democrats pushed to include a so-called “public option” in the bill – a measure for which the president's support wavered. It was eventually killed by then-Democratic Sen. (and former vice presidential candidate) Joe Lieberman.
Which brings us back to today.
If enacted, Sanders’s bill would begin extending Medicare-like coverage to people over a four-year transition period, with the eligibility age for the program—currently 65 and older—slowly lowered over time until it covers the entire population, according to WSJ. And while private insurers wouldn’t be permitted to compete with the government’s plan for basic coverage, consumers could purchase supplemental health policies.
The plan would also authorize the universal government health system to negotiate the cost of prescription drugs, an idea that conservative have said is tantamount to price fixing. The Sanders plan would also require abortion to be covered – an idea that will outrage evangelicals. Federal funds are presently prohibited from paying for abortions.
While hundreds of thousands of college students would probably rejoice at its passage (having free health-care coverage for life would certainly ease the psychic burden of not working), as author and former trader Nassim Taleb notes, “America is not Canada.”
As of Wednesday, 15 Democratic senators have signed on to support the bill. They are:
Tammy Baldwin (WI)
Richard Blumenthal (CT)
Cory Booker (NJ)
Al Franken (WI)
Kamala Harris (CA)
Mazie Hirono (HI)
Martin Heinrich (NM)
Kirsten Gillibrand (NY)
Ed Markey (MA)
Jeff Merkley (OR)
Brian Schatz (HI)
Tom Udall (NM)
Elizabeth Warren (MA)
Sheldon Whitehouse (RI)
Speculation about how Sanders will propose payment for the bill, which will likely be used as a template by Democrats in legislative battles for years to come, is already mounting. Here are a few ideas, courtesy of Axios.
- A 7.5% income-based premium paid by employers, which his paper claims will raise $3.9 trillion over 10 years. This would exempt certain small businesses.
- 4% income-based premium paid by households, which his paper claims will raise $4.2 trillion over 10 years. This would not affect low-income families.
- Savings from health tax expenditures, which his paper claims will raise $4.2 trillion over 10 years.
- Make the personal income tax and the estate tax more progressive, including limiting deductions for the wealthy. His paper claims this will raise $1.8 trillion and $249 billion over 10 years, respectively.
- "Establish a Wealth Tax on the Top 0.1 percent," which his paper claims will raise $1.3 trillion over 10 years.
- Add a fee on large financial institutions, which his paper claims will raise $117 billion over 10 years.
Of course, not all Democrats are so fond of Sanders’s plan. Shockingly, it’s least popular among the party’s leadership. Nancy Pelosi has said she wouldn’t endorse the bill because she’s focused on protecting Obamacare. Schultz’s successor, DNC Chairman Tom Perez, said something similar. In summary, single-payer has gained enough political momentum within the party to force its opponents to at least couch their position in an excuse.
Because if the 2016 election cycle taught the Democrats anything, it’s that they oppose populist movements at their own peril.