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Tell Your Member of Congress to Support Medicare for All

Health care is an issue close to the hearts of Indivisible groups, and Americans more broadly. Exit polls from the 2018 blue wave suggest that Democrats won in large part because voters were worried after months of Republican attacks on our health care system. Now that Democrats have won control of the House, it’s time for them to demonstrate that they are prepared to be both leaders in undoing the damage done by Congressional Republicans and the Trump administration and in reforming our health care system to guarantee health care coverage for all.

Representative Pramila Jayapal (WA-07) has introduced the Medicare for All Act, which will not only ensure universal coverage—it will improve the quality of coverage, while allowing the US to better control the cost of care. Call your Member of Congress (MoC) and tell them: co-sponsor the Medicare for All Act!

In this resource, we’ll tell you more about what’s in the bill and provide you with a call script you can use when you call your MoC.

Call your member of Congress and tell them: co-sponsor the Medicare for All Act!

Rep. Jayapal’s Medicare for All Act stands out because it provides comprehensive coverage with no premiums, co-pays, or deductibles. This bill would guarantee that every person living in the United States has access to health care services.

Get the Call Script!

What’s in Rep. Jayapal’s Medicare for All Act?

The United States spends more, per person, on health care than any other country in the world. Despite that, we have worse population health outcomes than many other high-income countries—and these outcomes vary greatly based on a person’s race, gender, income, and location. According to a 2018 study, care is expensive here because “prices of labor and goods, including pharmaceuticals and devices, and administrative costs” are much higher in the US than in other countries.

One reason for this is that there are so many “payers” in the US health care system. A payer is exactly what it sounds like—it’s the entity that compensates health care providers for their work. (Examples of “payers” are the various private insurance companies, of which an individual may have multiple, Medicare, and Medicaid.) Having so many payers causes complexity that in turn drives up the cost of everything from getting a prescription to getting an MRI. It also means that employers and providers (such as hospitals and medical practices) have to dedicate a lot of money to paying people who can handle billing all these different payers, and a lot of time to building systems that are equipped to deal with all of them and teaching people what their different coverage options mean. (It also means that our health care system is costly and confusing for an individual to navigate.)

The Medicare for All Act takes on both of these problems—the high cost of services and the high cost of administering our fragmented health care system—at their roots. Let’s take each of them separately.

Tackling the high cost of services. The cost of many services and pharmaceuticals is higher in the United States than in other high-income countries. This is due to a multitude of factors, many of which the Medicare for All Act would change in key ways:

  • It would set a budget to pay providers for the care they are expected to provide. That means providers will receive compensation from the government based on the amount they spent in previous years, which would help keep cost inflation low.

  • It would remove the issue of opaque pricing for medical services from the equation altogether by setting clear cost levels for procedures and other care. People with different types of insurance would no longer be charged different prices.

  • Finally, it would reverse the tide of explosive growth in the cost of pharmaceuticals by allowing Medicare to issue competitive licenses that would break patent monopolies for critical medications (like insulin) and allow generic production of those medications if a pharmaceutical company refuses to negotiate a reasonable price.

Bringing down high administrative costs. According to a 2014 study, administrative costs account for over 25% of all hospital costs in the US—a figure that is very high relative to other countries. The Medicare for All Act would reduce these costs and redirect them toward the provision of care by making some important changes:

  • It would shift us from a multi-payer system that has an overwhelming number of insurers, providers, and other variables to a single-payer system that would only have one payer—the federal government. By one estimate, this change alone could save our country $350 billion every year.

  • And, by creating greater certainty for providers, like doctors and hospitals, about the revenue they will have each year and by lowering their incentive to maximize profits, the Medicare for All Act would result in providers spending less on things like overhead and marketing.

There are several health care proposals from Democrats that would seek to build on the Affordable Care Act, expand Medicare or Medicaid, or some combination of those things.

Rep. Jayapal’s Medicare for All Act stands out because it provides comprehensive coverage with no premiums, co-pays, or deductibles. This bill would guarantee that every person living in the United States has access to health care services, including:

  • Primary care

  • Hospital and outpatient services

  • Prescription drugs

  • Dental, vision, and audiology

  • Women’s reproductive health services (including abortion)

  • Maternity and newborn care

  • Long-term services and supports (through home- and community-based services, unless the individual chooses otherwise)

  • Mental health and substance abuse treatment

  • Laboratory and diagnostic services

  • Ambulatory services

  • And more.

How will the Act improve our health care?

In addition to lowering costs and improving quality, this bill will also drive more just health outcomes along lines of race, gender, class, and geography. Disparities in insurance coverage are a persistent feature of our current health care system, and it hits communities of color, women, immigrants, working-class people, and rural areas the hardest. By setting a minimum standard of coverage and guaranteeing that people will be able to get the services they need, the Medicare for All Act will begin to close these gaps.

Under this bill, every person will have guaranteed access to maternity and newborn care, in light of the horrifying maternal mortality rate among Black women. It will mean that the failure of Republican-led states to expand Medicaid, where half of the population who would gain coverage are people of color, would be bypassed. It will guarantee that people in rural areas get the care they deserve, a stark improvement over the current increased rate of hospital closures. And it will guarantee that millions of Americans who currently delay or forego care because of its cost are instead able to see their doctor without fearing how they will pay for it. That’s because, under this bill, patients wouldn’t be responsible for premiums or deductibles, nor would they be responsible for co-pays or out-of-pocket costs. (Despite the insistence of some health insurance wonks, this idea of “cost-sharing” does not lead to anyone getting better care.) And critically, there wouldn’t be any “networks” that limit people’s ability to see the doctor they want to see. Patients will have complete freedom to choose whichever provider they want.

This bill is also the most inclusive health care proposal for immigrant communities. For years we've heard Democrats say they want universal access to health care; but, in practice, they've supported unnecessary and even harmful immigrant restrictions in health care proposals. This bill is the first major health care proposal that would expand access to all families in the U.S. regardless of their immigration status. This is not just morally right, but also good policy in that healthy communities are better for all of us. Period.