Sep 13, 2017, 9:13 PM ET

Here's what's in Bernie Sanders' 'Medicare for all' bill


It was a big day on Capitol Hill for Sen. Bernie Sanders and the debate over health care policy in the United States. Surrounded by a dozen of his Democratic colleagues, nurses, doctors and patient advocates, the Vermont introduced the latest version of his health care bill Wednesday, a proposal he refers to as "Medicare for all."

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"Today, all of us stand before you and proudly proclaim our belief that health care in America must be a right, not a privilege," Sanders said.

Sanders' bill, based on an idea central to his 2016 presidential bid, would open up the current Medicare insurance program to all American citizens and residents. The federal government would pay the cost of insurance, premiums, deductibles and most co-pays, effectively eliminating the majority of out-of-pocket medical costs for Americans. Like with the current Medicare system, patients would still primarily receive medical services at private institutions. Matt Fielder, a health care policy expert at the Brookings Institute describes the concept this way during an interview with ABC News, "Single payer is about who pays the bills not who delivers the care."

Sanders' bill does not attempt to answer the question of financing, how the government would pay for the significant expenses his proposal would require. While the plan has not received a score from the Congressional Budget Office, experts have estimated the proposal could cost the government approximately $3 trillion a year.

"While, depending on your income, your taxes may go up to pay for this publicly funded program, that expense will be more than offset by the money you are saving by elimination of private insurance costs," he continued during his fiery speech on Capitol Hill on Wednesday.

He said U.S. health care is in a "crisis" and that special interest groups have contributed to rising costs.

"The crisis is a political crisis that speaks to the incredible power of the insurance companies, the drug companies and all those who make a billions of dollars off of the current system," Sanders said. "Over the years these entities have done everything they can do to prevent us from having lower drug prices and universal health care."

Here's a closer look at some of the bill's proposals:

  • The bill includes a transition period. In the first year, children up to age 18 and adults over 55 would be eligible for Medicare. (Currently, most Americans are not eligible until they are 65.) Over the next three years the pool would be increased, until eventually citizens and permanent residents of all ages were eligible for the government insurance program, which would cover essential health benefits such as emergency services, primary and preventive services, ambulances, maternity care, substance abuse care and other services.
  • The bill also calls for the services and care covered by traditional Medicare to be expanded to include dental, vision and hearing aids.
  • The bill allows the federal government and expanded Medicare system to negotiate drug prices.
  • Medicaid, veterans insurance programs and hospitals and other government run insurance programs would remain.
  • Private insurance companies could still offer private coverage plans to supplement the Medicare coverage.
  • During the transition period, the federal government would offer a so-called public insurance option that would compete against private insurance plans in individual insurance marketplaces.
  • Elizabeth Warren described the proposal as a plan to build on the Affordable Care Act, though the bill would in fact take a very different approach. Instead of the government subsidizing private insurance, Sanders' bill would create a government-run insurance program.

    "Barack Obama, who helped build the game changer that gave millions of Americans, who didn't have health care coverage, new health care coverage. We are here today to take another step. We will not back down in our protection of the Affordable Care Act. We will defend it at every turn. But we will go further. And we will say that in this country everyone, everyone gets a right to basic health care," she said.

    Dr. Danielle Martin, a Canadian physician, discussed the benefits of universal coverage at the event on Capitol Hill. "My generation of Canadians does not remember what it was like to worry about paying a doctor or hospital bill."

    Sen. Corey Booker, D-N.J., a co-sponsor on Sanders' bill, lamented that other developed nations had found ways to provide universal coverage and limit costs, while still experiencing health care outcomes at times better than those in the United States.

    "This is a defining moment of the character of our country. How can we get the greatest nation on the planet earth have the most expensive health care system," Booker said, adding. "It is embarrassing to me ... to have a Canadian stand here in the capital of the United States of America and talk about a system that takes care of their children better than we take care of our children."

    Fiedler said that countries with socialized systems of health care have been able to cut costs.

    "It is certainly the case that other countries spend considerably less on health care," Fiedler told ABC News in a phone interview. "A big component is they pay the medical providers, doctors and hospitals and drug manufacturers, less than we do in the United States. It is quite plausible that a single-payer system, because of the bargaining power of the single payer would have, at least in principle, could wring out some of those savings from the U.S. system."

    Still, Fiedler added that many questions remain about how exactly a program like Sanders' would work in the United States.

    "The federal government would now be paying for health care for more than 150 million people who now get their health insurance through the private market and that would be very expensive. I think question to financing to pay for that care is a hard one," he went on. "I think that transition would be a messy one."

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    • Klemper

      Thank God we have Obamacare. Shut up Bernie... your party fixed this already... Or did you?

    • Chuck

      More corporate lies to keep the sheep divided and uninformed. In a corporatocracy they get all the advantages and benefits, not the people who actually pay for it. We live in one of those today. If we would stop bombing everyone and keeping ourselves in perpetual war, we could afford it no problem. The new Military jet is going to cost that alone. Stop giving countries like Isreal 4+ billion a year so they can have Universal health care and maybe our own citizens could have it too. Every modern country on earth has it but we don't. Just keep lining the pockets of politicians and CEO's and soon we'll be a 3rd world country like they want.

    • Now Look Sad and Say D'oh

      Uh, Bernie, I think you skipped kind of a big step here: "Sanders' bill does not attempt to answer the question of financing, how the government would pay for the significant expenses his proposal would require."

    • gamersglory

      Medicare is Better than most insurance plans i've had and adding Dental and vision will make it better then any insurance i've had.

    • the jolly llama

      Here's an idea... lets stop spending so much taxpayer money on the 800 military bases we have in 70 nations across the globe and make American healthcare more of a priority.

    • mountaingirl39

      folks still need to remember that medicare coves 80% of the benefits after a deductible for part A(Hospitalization) and part b (doctors). They would still have a 20% responsibility they would pay unless they purchased a supplemental plan. Don't let Bernie hoodwink you into thinking that he can snap his fingers and folks have coverage paid 100%, it's not.

    • food for thought

      If we go to a single payer system, will all healthcare providers and facilities be required to participate and accept what the government thinks each procedure and visit are worth? If they can opt out as they can today with Medicare then we might see the best doctors and hospitals only accepting cash patients.

    • pfon71361

      At an estimated cost of three trillion dollars a year and President Trump also wanting a major corporate tax reduction, this single-payer Medicare plan will have tough going in the Republican controlled congress. The national debt is already 20 trillion dollars and this proposal, if implemented, is likely to exacerbate that. The anticipated offsetting cost reductions in private insurance may look good on paper but the bloom on the rose may fade when the very large additional health care tax starts to bite. While an all-inclusive and affordable national health care system is a worthy objective, the real net cost to everyone should be carefully weighed before any comprehensive bill is passed. The adage "an ounce of prevention is worth a pound of cure" should apply to our fiscal well-being as well as our physical one.

    • Kelly Welch

      Couldn't some of the cost be offset with money from companies who already subsidize their employees insurance? If not, and they don't bump up peoples salaries by that amount, then it's another win for corporate america!!!

    • AlanMacDonald

      My comment to the NYT re. Bernie ONLY addressing the Health Care problem of this EMPIRE:

      Bernie's heart is in the right place --- it's just that his slow incrementalist
      thinking and weak-kneed "Political Revolution" weren't.

      What he really needed to shout-out in his speech yesterday was:

      "We remain the only major [Empire] on earth that allows chief executives
      and stockholders in [all 7 sectors of this Empire] to get incredibly
      rich, while tens of millions of people suffer because they can’t get the
      [democracy] they need. This is not what the United States [started a
      "Revolution Against Empire" Justin duRivage] to be about."

      Bernie's two-word sound-bite and incomplete call for a "Political Revolution" --- Against what Bernie? --- missed the mark in not firing a; loud, public, sustained, 'in the streets', but completely non-violent "Shout
      (not shot) heard round the world" to ignite an essential Second American
      people's peaceful patriotic "Political/economic and social Revolution
      Against Empire" --- as our forefathers started 242 years ago, and
      intended to be 'perfected' of, by, and for the people.

      As our forefathers fully understood, it is never treasonous, and always patriotic, to ignite a "Revolution Against Empire"

      And as Pat might have shouted if Tom had taken the pain to edit his words: "Give me Liberty [from Empire], or Give me Death"

    • Where's the Revolution

      Schumer and Pelosi are predictably not backing Bernie's plan. Their donors from the health insurance and big pharma lobbys want to go back to the old system.

    • Margaret

      We need to focus on the healthcare of our citizens over useless military spending the majority of citizens dont want. private insurance companies and big pharma are raking in record profits while making it extremely difficult for most people to afford the coverage and services they need. If it were easier for more people to get preventative care, the higher costs of treatment down the road would be averted, which saves money for everyone.

    • rascal

      I have been working and paying taxes for over 35 years... I make a good salary a year.. I am just self-employed. Looks like next year, I will not be able to buy an individual policy in my county. Even though I can afford to pay for health insurance, I will not be able to buy it because it will not be offered to me.
      Don't have a clue what we will do... 58 years old and for the first time in my life I will not be able to buy HC for me or my family.

    • proudrepublicanvet

      This plan is an Insurance companies dream. Make as much money on part b as you do covering health insurance today. Bernie will stick it to us Americans with his stupid break me plan. If this where to pass I would buy into insurance right away and sit back and enjoy all the money I am making ....

    • Phoenix Punk

      I called Metlife to find out why my auto ins went up 30 a month. They said because health care in AZ was on the rise.

    • Baltoga

      The problem I see are the last three items:
      1, Medicaid, veterans insurance programs and hospitals and other government run insurance programs would remain.
      2. Private insurance companies could still offer private coverage plans to supplement the Medicare coverage.
      3. During the transition period, the federal government would offer a so-called public insurance option that would compete against private insurance plans in individual insurance marketplaces.

      If you expand Medicaid, but keep these programs intact how are you going re-coup costs?

    • retired too

      3 trillion a year?? and you can bet that's a low estimate just cannot afford that no matter how well intentioned