Tell Your Member of Congress to Support Medicare for All

Health care is an issue close to the hearts of Indivisible groups, most notably since mobilizing to stop GOP attacks on the ACA in 2017. The COVID-19 pandemic has laid bare just how cruel our healthcare system is by leaving nearly 100 million people uninsured or underinsured and ravaging our most vulnerable communities. We must once again plan to fight for our right to health care—universal, equitable, affordable, and culturally-competent health care.

Now that Democrats have won control of the House, Senate, and the White House, it’s time for them to demonstrate that they are prepared to be leaders in both undoing the damage done by Congressional Republicans and the Trump administration and in transforming our healthcare system to guarantee health care to every person in the U.S., regardless of immigration status, disability, gender identity, income, or geographic location.

On March 17th, 2021, Representative Pramila Jayapal (WA-07) 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 to co-sponsor the Medicare for All Act!

In this resource, we’ll tell you more about what’s in the bill.

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.

Numerous studies have found that by transitioning to a single-payer healthcare system, the U.S. would greatly reduce expensive administrative costs, expand coverage to every person in the country, and leverage the federal government’s bargaining power to prevent price-gouging.

The U.S. healthcare system currently allows many “payers” to participate, making the system wildly-complex and requiring countless levels of administrative bureaucracy to function. 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 medical providers 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 equip people to understand what their different coverage options mean. (It also means that our healthcare 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 encourage everyone in the U.S. to seek necessary preventative care, instead of putting off medical attention—for fear of cost—until their health issue is life-threatening, requiring more expensive treatment.

• 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. Nearly one-third of the money that the U.S. spends on health care goes directly to administrative costs.—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 save our country more than $500 billion a year.

• And, by creating greater certainty for medical providers like doctors about the revenue they will have each year and ensuring transparency in actual cost of services, 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 is truly the most equitable proposal because it provides comprehensive benefits to every person living in the United States without copays, private insurance premiums, deductibles, or other cost sharing. This bill would expand upon the current Medicare benefits by guaranteeing access to:

• 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 for all ages and disabilities, unless the individual chooses otherwise)

• Mental health and substance use treatment

• Laboratory and diagnostic services

• Transportation to medical services for individuals with disabilities and low-income individuals

• 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 healthcare 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, which is needed to address the horrifying maternal mortality rate in the U.S—a ratio more than double that of other high-income countries. 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.

Enacting Medicare for All 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 nearly 1 in every 2 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 the most inclusive and equitable 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 the COVID-19 pandemic demonstrated how healthy communities are necessary and better for all of us. Period.