Medicare-for-all advocates say the coronavirus pandemic makes their case.
The public health crisis, they say, boosts their arguments for a single-payer system and the comprehensive, affordable coverage it promises – even after a presidential primary in which Democratic candidates inched away from the controversial idea of overhauling the U.S. health-care system to have it resemble the nationalized programs in other countries.
People have lost their employer-sponsored health plans at record rates as unemployment skyrockets. It took weeks to ramp up testing in a clunky and complex health-care system. Some people are still getting billed for coronavirus-related testing, despite laws requiring it to be fully covered.
“I hate to say we needed a crisis like this because it has caused so much devastation, but certainly the crisis has highlighted the human toll of our broken health-care system,” Rep. Pramila Jayapal. D-Wash., sponsor of the House Medicare-for-all bill, told The Washington Post.
Jayapal hopes Joe Biden will use the coronavirus crisis to push for more dramatic changes than he previously backed.
Medicare-for-all is politically far out of reach: Its prospects faded further when Jayapal’s preferred pick for president, Sen. Bernie Sanders, I-Vt., conceded the primary race to the former vice president. Biden, a critic of Medicare-for-all, has argued for a government-run “public” option to be offered alongside private plans, although he recently gave a nod to progressives by proposing Medicare’s eligibility age be reduced by five years to age 60.
Now Jayapal is playing a role advising Biden. She was appointed by Sanders to a health-care task force intended to unify the Democratic Party and provide recommendations to the nominee as the November election approaches, and she’s still making her case.
“I think this is a real opportunity for Vice President Biden to really make the case for all of the structural changes that need to be made that we are seeing having come to light during covid,” she said.
The pandemic has indeed ballooned the problems within the U.S. health-care system.
The nation’s tussle with the virus – which had claimed the lives of at least 97,000 people in the United States as of Memorial Day – has highlighted many of the practical problems that Biden, Sanders and the rest of the Democratic field spent the past year fiercely debating.
Foremost among them: what happens to people when they lose their jobs and the medical coverage that comes with it. Politicians across the political spectrum, including some Republicans, have long argued that there’s good reason to decouple coverage from the workplace.
The threat of losing employer-sponsored coverage has now become a reality for an estimated 27 million Americans.
They’re among the more than 38 million people who have filed unemployment claims across the country.
The situation illustrates how quickly the loss of a job can upend one’s health insurance. For Jayapal, that strengthens the argument for Medicare-for-all, which would guarantee everyone a government-backed plan covering a range of services at little or no out-of-pocket cost. (Although wonks agree it would also cost the government a huge sum of money.)
“All of a sudden, the argument that health care shouldn’t be tied to employment makes a lot of sense to people because there are so many people who lost their employer,” Jayapal said.
Sanders struck a similar tone, tweeting “It is catastrophic that tens of millions of Americans are losing their health insurance-on top of the millions already uninsured.
Medicare must be empowered to cover all health care expenses during this crisis.
We can not abandon the American people.”
Those who have lost their employer coverage do have some options: Existing federal laws allow those who have lost health insurance as part of losing their job to enroll in a plan on healthcare.gov at any time during the year. And families receiving the supplemental employment benefits provided by Congress are within the income threshold to qualify for subsidies, according to the Kaiser Family Foundation.
There’s also Medicaid coverage, though in some states that haven’t expanded the program, eligibility is generally set at a particularly low threshold. People can also consider signing up for a short-term health plan expanded by the Trump administration or continuing their group coverage for a limited time under COBRA, but that’s typically pretty expensive.
Polls show a majority of Americans are skeptical about something as dramatic as Medicare-for-all, in which private coverage would be done away with. But they’re more open to letting people choose to buy into the program.
Steep job losses among older Americans could strengthen Biden’s proposal to slightly expand Medicare eligibility, KFF President Drew Altman argued in an Axios column. He noted that unemployment among 55- to 64-year-olds is up to 12.5 percent due to shutdowns. That translates into a steep loss of health coverage among this group.
“Millions of uninsured 55-65 year-olds could add new urgency to calls for a Medicare buy-in if Democrats control the White House and Congress in 2021,” Altman wrote.
The coronavirus also highlights the lack of health-care affordability in the United States, even for the insured.
Even Americans with generous coverage are vulnerable to high deductibles and unexpected “surprise” medical bills after receiving out-of-network coverage through no fault of their own. In the case of testing and treatment for covid-19, the disease caused by the coronavirus, insurers aren’t always following measures signed by President Trump to protect patients from any additional costs, as Business Insider recently detailed.
And prices for medical procedures and prescription drugs are considerably higher in the United States than in any other developed nation.
That reality raises concerns about ensuring that every American is able to get a vaccine for the coronavirus once one is developed.
Congress was trying to tackle some of these problems before the pandemic. Lawmakers were forced to put multiple bills on the back burner as they rushed to respond to the crisis with multiple enormous relief bills.
But the needs presented by the virus ensure these systemic problems are front and center – even if there’s no consensus on whether the best solution is Medicare-for-all, a public option or something else.
“Our broken, for-profit system left people vulnerable to covid-19 in a way that they would not have been,” Jayapal said.
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