There’s been a lot of talk about Medicare for All and how it might change health coverage in America. But what is it, specifically? Is it a law yet? Will it become law soon? And what does it mean for you and your family? Get the facts about Medicare for All, the pros and the cons, right here in this article.

What is Medicare For All?

The Medicare for All Act was originally proposed by Vermont Senator Bernie Sanders in 2017 and was further discussed during the 2020 Presidential election. The plan’s aim is to provide one source of health insurance for all Americans. Millions of Americans are currently without insurance, which has seen many deaths that may have been prevented otherwise.

After much controversy about the Affordable Care Act (ACA), also known as Obamacare, politicians, and citizens of America have been searching for a better alternative for health care nationally. This decision will indeed affect everyone, as it will change the way we view health care in this country – and will ultimately change the kind of care we will receive, too.

The coverage that will likely be provided includes:

  • Hospital services, inpatient and outpatient hospital care, 24/7 emergency services, and inpatient prescription drugs
  • Ambulatory patient services
  • Primary and preventive services, including chronic disease management
  • Prescription drugs, medical devices, and biological products
  • Mental health and substance abuse treatment services
  • Laboratory and diagnostic services
  • Comprehensive reproductive, maternity, and newborn care, including abortion
  • Pediatrics
  • Dental health, audiology, and vision services

What Is the Medicare For All Act of 2021?

In 2021, Representatives Pramila Jayapal and Debbie Dingell introduced Bill H.R. 1976 — also known as the Medicare For All Act of 2021. This advances plans for universal health care coverage, freedom to choose who provides you medical services, and eventually other benefits such as the comprehensive coverage outlined in the previous section.

In the bill, the goal is for a single-payer program with no co-pays, no private insurance premiums, and for health care to be treated as a basic human right for Americans. Also, as previously stated, it would not be limited strictly to those 65 and older. In fact, if the bill passes, newborns would be enrolled at birth, guaranteeing them health care coverage for life.

Even with this bill being in front of Congress, there are still different schools of thought on which would be the best way to run a Medicare for All program.

Medicare For All – Those Who Want It (The Public Option)

There are two proposals for Medicare for All: a public option, and a single-payer system. The public option includes automatically enrolling all eligible American citizens in health care. Citizens will only be able to opt out of it if they have private, government-approved health care replacement coverage.

Another aspect is the cost of the public option. If you fall below 200% of the poverty line, you will not have to pay additional health care taxes. If you are above the line, there will be an income-based annual health care tax. The idea here is to tax those that are in a better financial state because they will be more likely to afford it. Those who are fully funded will be covered by both the federal government and other taxpayers.

The public option gives citizens the opportunity to choose whether they want universal health care or not, instead of forcing it on them. According to current legislation proposals, the public option would function similarly to the way the ACA works now.

But critics of the public option point out that letting private, for-profit health insurance companies continue to play such a large role in the healthcare system will likely keep medical costs higher than they need to be.

Medicare For All – Mandated (Single-Payer System)

The latter option for Medicare for All is the single-payer system. This mandated system proposes using funds from corporate taxes, marginal taxes from wealthy citizens, and income tax from both state and federal health insurance companies pre-existing.

Most out-of-pocket costs are subject to be eliminated with the single-payer system. This proposal will attract many Americans because that means the majority of them will not have to pay directly. Therefore, instead of paying for your health care, the federal government will pay the cost to your providers instead.

The Pros of Medicare For All

So why is the topic of Medicare for All controversial? Won’t it benefit everybody? Not necessarily. There are plenty of good reasons to support legislation like Medicare for All – but at the same time, nothing is perfect.

More Americans Will Receive Medical Care

The age eligibility for Medicare for All will gradually go from 55 to no age restriction within a 4-year transition. This transition plan will allow all members to have full coverage. In year 2, it will go to 45, year 3 will be 45 years old, and in year 4 everyone residing in America will be eligible for Medicare for All.

Yet, during the first year, resident children from newborn to 18 years old can apply to the Universal Medicare Program. This allows for all children to still have access to health care before the transition period is over. The Original Medicare program did not include aid for children and families, unlike Medicaid. So, including people of all ages would be a step in the right direction for the country.

Medicare For All Will Save Lives

For those lucky enough to have full health care coverage, they know how much of a literal lifesaver it can be at times. Unfortunately, there are roughly 100 million people considered to be underinsured or have no health insurance. Because of this, they are at a much greater risk. It’s estimated that almost 45,000 people without health insurance die yearly that would have otherwise survived had they had health coverage.

Medicare For All would hopefully eliminate that number while also allowing those on it to live higher-quality lives

Out-of-Pocket Costs Would Be Eliminated

The Medicare Single-Payer System proposed by Representatives Jayapal and Dingell no longer include co-pays for things like brand-name prescription drugs. It is an improvement from ACA since any kind of co-payment tends to deter customers away from a plan. Depending on a patient’s condition, co-payments can start to add up in the long run.

No More Restrictive Medical Networks

Patients get to choose their doctor/hospital providing they are participating in Medicare for All. Similar to indemnity plans, members will be able to have much more say in their health care. Having the choice of doctor and hospital can make all the difference in choosing a health plan.

For example, someone who has been diagnosed with cancer would want their primary physician to specialize in patients with cancer to ensure they will receive the best care. Medicare for All will include hearing, dental, and vision care (which is not the case currently).

This plan will cause fewer issues with insurers, less paperwork, and less time spent on administrative tasks – thereby freeing up more time to treat patients.

Alleviates Health Insurance Burdens for Companies

Medicaid for All will take most of the onus off of employers to provide health insurance for their employees. By doing this, employers will not have to worry about providing their staff with health care and instead focus on bettering their business.

Not only that, but many Americans have also admitted to staying at a job they do not like simply for the health benefits it may entail. This causes many working adults to be overstressed and underwhelmed with their careers, leading to unhappy workers.

With that being said, it will still be an option for employees to have private health care if they choose to purchase qualifying coverage instead. Additionally, private insurance would only be used as a supplement for services and treatments that are not offered through Medicare for All.

The Cons of Medicare For All

Yes, there are some less-than-positive sides to a Medicare for All system. And all American citizens should educate themselves as to what they are before this proposed legislation comes up for a vote in Congress.

Some New/Increased Taxes Will Be Necessary to Pay for Medicare

A negative aspect of this plan is that the public will pay for this health care through taxes. Taxpayers in higher income brackets will feel the cost of this plan the most as they will be paying for it alongside the government.

In 2018, health care costs in the U.S. were nearly $3.6 trillion. The projected amount of money likely to be spent throughout the next decade is $45 trillion. The common misconception is that the single-payer system will eliminate the costs of healthcare; but in reality, it shifts the financial burden away from those who can’t afford it and more toward those who can.

Current local, state, and federal tax revenue programs for Medicare and Medicaid will fund Medicare for All. Those funds – along with increased corporate taxes and a nominal annual tax on those in upper-middle-class tax brackets and above – will all contribute towards covering the costs of Medicare for All.

The Healthcare System May Be Overburdened (at First)

Automatically enrolling all American citizens into Medicare For All may seem like a good idea at first, but it could cause an initial strain on the system. Some say that putting health care at such a low cost and giving access to everyone will put many providers out of business.

It will be more difficult for them to care for very sick patients without immediate funding for it. There has been research conducted with other nations that participate in the single-payer system; as far as co-payments, it has been found to not negatively affect cost control.

What To Do Until Medicare For All Gets Passed

Since Bill H.R. 1976 hasn’t passed yet, Medicare For All is still a very good idea. But it’s not certain it will come into effect. Until a decision has been made by Congress, you should make sure your health care is as comprehensive as possible.

That’s why looking into a Medicare Supplemental plan to close the gaps in your current coverage can be beneficial. Our licensed insurance agents will answer all of your questions and can explain exactly how a supplemental plan will work.

Call today to talk to our agents — free of charge — or fill out our simple online rate form to get connected with the best rates in your area.

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by Lindsay Malzone, Lindsay Malzone is the Medicare expert for Medigap.com. She's been contributing to many well-known publications as an industry expert since 2017. Her passion is educating Medicare beneficiaries on all their supplemental Medicare options so they can make an informed decision on their healthcare coverage.