Here we are celebrating the extraordinary American moon landing achievement of 1969. It was also the time of great advances in civil rights, in health coverage for seniors, the disabled and the poor, and of a nation divided by the Vietnam War and the end of legal segregation – the American version of apartheid.
Financing Medicare for All is far better done at the federal than at the state level. Senator Sanders and others seek to do so in both the Senate and the House and it's a key issue in the Presidential campaign.
For the next decade, we will be running annual budget deficits equal to about 4.5% of GDP as compared to the last 50 years where it was 2.9% of GDP. The levels of budget deficits will require an increasing share of the federal budget to be spent on interest payments to those who hold Treasury notes and other federal securities. Federal taxes are bringing in revenues of roughly 16% of GDP while federal spending is running at about 20.5% of GDP. The Presidential election in 2020 is crucial to the nation’s financial future.
The Medicare for America Plan, HR 2452 (DeLauro and Schakowsky), gives all Americans a choice of Medicare or private insurance. Individuals can choose public coverage through Medicare or private coverage through their employer or private coverage through a Medicare Advantage plan.
There are four Public Option bills – S 3 (Cardin), S 1261 and HR 2462 (Merkeley and Richmond), S 981 and HR 2000 (Bennett, Kaine and Delgado), and HR 2085 and S 1003 (Schakowsky and Whitehouse) . They give participants in the Exchanges (like Covered California) the option to choose a plan offering Medicare coverage. Some increase premium assistance and cost sharing reductions; others do not. All leave existing coverage through Medicare, Medicaid, CHIP, and employer plans unchanged.
There are two different Medicare for All Plans in Congress: Senator Sanders S 1129 and Representative Jayapal’s HR 1384. They are comparable, but with a few salient differences. Both cover all Americans for a comprehensive set of benefits with no cost sharing or premiums, using a Medicare-like payment program. Both eliminate all employer and individual private insurance and the existing Medicare program and most of the Medicaid program as well (Senator Sanders retains it for institutional long term care – i.e. nursing homes. Neither eliminates the VA programs for veterans or the HIS program for Native Americans.
Covered California released its initial report on premiums, premium assistance and plan participation for the coming year (2020). Premiums are down; plan participation is up; coverage is more affordable, and subscriber participation is expected to increase.