Seattle
Times (WA) February 27, 2019
Feb. 26-- Feb. 26--U.S. Rep. Pramila Jayapal is introducing
a Medicare-for-all bill that would create a government-funded, single-payer
health-care system to cover every person in the United States.
The proposal, which has 107 co-sponsors, is even more
ambitious in scope -- covering more services, more quickly -- than the
Medicare-for-all bill previously proposed by Vermont Sen. Bernie Sanders. And
it comes not from a two-time presidential candidate but from Jayapal, a
second-term Seattle Democrat who's fast becoming an influential leader of
national progressives.
Jayapal, the co-chair of the Congressional Progressive
Caucus, leads a group of 96 House members that's begun to assert significant
sway on the Democratic Party.
In January, Jayapal garnered better committee assignments
for her caucus in exchange for supporting Rep. Nancy Pelosi as House speaker.
Then she extracted a guarantee that her Medicare-for-all bill would get
hearings in exchange for backing a rules package that Pelosi wanted.
"Pramila Jayapal is a lifelong organizer. What will
she do now that she's one of the key players in Congress?" The Nation
magazine asked, putting Jayapal on its cover two weeks ago.
Jaypal's new legislation, to be unveiled Wednesday, would
expand not just who's covered by Medicare but also the services Medicare covers.
It would pay for primary care but also prescription drugs, dental and eye care,
long-term care, reproductive health care and mental-health and substance-abuse
treatment.
Patients would not be charged premiums, co-pays or
deductibles.
The bill does not say how the massive increase in
government health-care spending would be funded.
A study of Sanders' proposal found it would increase
government health spending by more than $32 trillion over 10 years but lower
the amount of overall health-care spending by virtually eliminating
individuals' health-care expenditures.
Jayapal said she had broad funding sources in mind --
higher taxes on the wealthy, premiums paid by employers, a higher corporate-tax
rate, the repeal of the recent Republican tax cuts -- but that those could come
later.
"The question is not about how we pay for it,"
Jayapal said. "The question is where is the will to ensure that every
American has the health care they deserve."
The bill would move everyone to a single-payer system
within two years of passage.
In a conference call with reporters Tuesday, Jayapal
ticked off earnings and salaries of insurance companies and their executives.
"The only people who cannot afford the cost of a
Medicare-for-all program of universal health care are these companies and CEOs
that stand to lose their massive profits," Jayapal said. "Why is it
that other major countries can guarantee universal health care for half the
cost of Americans?"
Last year, some of the nation's biggest health insurers,
hospital coalitions and pharmaceutical organizations formed a new group to
counter the push for single-payer health care -- the Partnership for America's
Health Care Future.
"This costly, disruptive one-size-fits-all proposal
is the wrong path forward," Lauren Crawford Shaver, the group's executive
director, said of Jayapal's bill. "The price tag would be enormous."
Under the bill, hospitals and other health-care facilities
would receive quarterly lump-sum payments from the government, based on their
historical service levels and other factors, to provide covered health-care
services rather than being paid for each service they provide.
"Physicians will have to figure out how they keep a
population healthy within those budgetary constraints," Jayapal said.
Private health insurance that duplicates the services
covered under the government-run program would be prohibited, but insurers and
employers could continue to offer supplemental coverage. Medicare could
negotiate with pharmaceutical companies -- something it's currently prohibited
from doing -- to lower the cost of prescription drugs.
With 107 co-sponsors, Jayapal's bill has slightly less
than half of House Democrats on board. In the Senate, Sanders' Medicare-for-all
bill counts three other Democratic presidential candidates among its
co-sponsors.
But, unlike the Senate bill and a previous House bill,
Jayapal's bill is likely to get hearings, after Jayapal secured the pledge from
Pelosi.
"This is a real plan, it's been developed over
months, it has an unprecedented coalition of support," Jayapal said.
"We will be pushing it as far as we can, as hard as we can, as fast as we
can."
The bill still has little chance of passage in the House
and no chance of passage in the Republican-controlled Senate. But advocates
said it was important to lay out an agenda for Democrats before next year's
elections.
"In thinking about 2020, in thinking about both the
Senate and the presidential race, this is a moment for us to put a marker down
about the type of country we are trying to build," said Jennifer
Epps-Addison, president of the Center for Popular Democracy, a progressive
advocacy group.
(c)2019 The Seattle Times
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