On Wednesday, Sen. Bernie Sanders, I-Vt., who is running in Democratic primaries, reaffirmed his stance on health care by reintroducing a "Medicare-for-all" bill, the idea that fueled his 2016 presidential run.
As with its previous iterations, Sanders' latest bill would establish a national, single-payer Medicare system with vastly expanded benefits. Sanders' plan would also prohibit private plans from competing with Medicare and would eliminate cost-sharing. New in this version is a universal provision for long-term care in home and community settings (though Medicaid would continue to cover institutional care, and states would determine the standard of eligibility).
Reactions from both sides are mixed:
"Before policies get defined, what you see is people endorsing a plan that is a little, perhaps, less subject to early attack," says Celinda Lake, a Democratic pollster with Lake Research Partners. "A lot of candidates feel if they endorse a plan that leaves some private insurance, they get more time to say what their ideas are about."
"The ACA is popular at the 50 percent level, but it's not energetic," says Robert Blendon, a political analyst at the Harvard T.H. Chan School of Public Health. "It doesn't get people who really like it. What they're looking for is something that is exciting but isn't threatening."
Most candidates have refused to take a hard stance on healthcare. Reading between the lines, though, their promises to achieve universal health care by expanding Medicare — while retaining private insurance — leave them few options aside from something like "Medicare for America," argues Jacob Hacker, a political scientist at Yale University and one the proposal's main architects.
"There are variations besides this particular plan, but once you start to actually dig into this, if you want universal coverage you're going to have to do the kinds of things" spelled out in "Medicare for America," Hacker says.
"The fact of expanded Medicare will be the focus of attacks," says the Commonwealth Fund's David Blumenthal.
Bernie Sanders remains determined:
“It is the vice president who determines what is and is not permissible under budget reconciliation. I can tell you that a vice president in a Bernie Sanders administration will determine that Medicare for All can pass through the Senate under reconciliation and is not in violation of the rules,” Sanders said in a statement after introducing the bill on Wednesday.
“Currently, only 15 out of 47 Democrats have publicly stated their support for that legislation, and that has got to change,” Sanders said. “In my view, Democratic elected officials and candidates should do what grassroots Democrats want them to do. Once we have, and I believe it will be sooner than later, a Democratic majority who are prepared to vote for Medicare for All in the House and Senate, we will pass it.”