As the 2024 election approaches in the United States, Medicare for All remains an important topic. If enacted, Medicare for All would change Medicare as we know it.
This would have a huge effect on the roughly 65 million Americans who are currently enrolled in Medicare. That’s about 1 in 5 people.
As a Medicare beneficiary, you may wonder how exactly Medicare for All could affect your coverage. Let’s explore what Medicare for All would look like in America and how it might change Medicare for anyone currently enrolled.
Medicare for All would transform the program into a single-payer health insurance program that would provide all Americans with healthcare coverage.
Single-payer healthcare systems, also called universal healthcare, are currently in place in various countries worldwide. These healthcare systems can have differing elements, such as:
- how the health insurance is paid for
- how the healthcare is delivered
- how the health facilities are owned and operated
For example, in Canada, the government administers health insurance, but professionals in private practice perform healthcare services. Alternately, in the United Kingdom, health insurance is administered publicly and healthcare services are performed in publicly run health facilities.
The Medicare for All proposal calls for a healthcare system similar to the one in Canada by expanding Medicare. Politicians such as Vermont Senator Bernie Sanders, a member of the Independent party, have championed the proposal.
This expansion to Medicare would include all necessary healthcare services, with no upfront cost to beneficiaries. As with most other tax-financed, single-payer systems, the cost of all healthcare services would be paid for through taxes.
Learn more: “Medicare for All vs. Single-Payer“
The current proposal for Medicare for All would consist of a Medicare expansion.
Currently, Medicare covers only Americans ages 65 years and older, as well as those with certain chronic health conditions. Medicare beneficiaries are currently covered for:
- Medicare Part A, which covers inpatient and outpatient hospital services, home healthcare, nursing facility care, and hospice care
- Medicare Part B, which covers preventive care, diagnostic services, and treatment services for medical conditions
- Medicare Part D, which helps cover prescription drug costs
Under the current proposal, Medicare for All would expand Medicare to include all necessary health services, such as:
- inpatient services
- outpatient services
- long-term care
- dental care
- vision care
- hearing care
- prescription drugs
Medicare for All would be run and funded by the government and would be available to every single American citizen. It would eliminate many of the elements associated with the current Medicare system, such as:
- private insurance plans
- age requirements for enrollment
- yearly deductibles
- monthly premiums
- copayments or coinsurance during visits
- high prescription drug costs
Medicare for All would be an expansion and overhaul of Original Medicare. This means that Medicare as we currently know it — Medicare Part A, Part B, Part C, Part D, and Medigap — may no longer exist.
In 2023, 51% of all Medicare recipients were enrolled in a Part C (Medicare Advantage) plan. The elimination of this type of plan would affect a huge number of beneficiaries, some of whom prefer Medicare Advantage simply because it is a private option. There are also additional benefits to Medicare Part C, including increased medical coverage and savings on medical costs.
That said, health coverage under Medicare for All could potentially include all the services under current Medicare Advantage plans and more. All of this would be offered with no premiums, deductibles, or upfront costs. It would be available for all Americans, regardless of age, income, or health status.
During his presidency, U.S. President Joe Biden passed legislation to strengthen the Affordable Care Act (ACA) enacted under President Barack Obama in 2010.
This led to a surge in enrollments and record-low uninsured rates, particularly in states without expanded Medicaid. However, with subsidies set to expire and budget cuts, more individuals may become uninsured.
Additionally, Biden fulfilled his promise to allow Medicare drug price negotiations through the Inflation Reduction Act. This led to changes such as reducing the cost of insulin, the expansion of subsidy programs, and a yearly cap on out-of-pocket prescription drug costs.
Currently, two Medicare for All proposals are going through the House and the Senate:
- the S.1655 – Medicare for All Act proposed by Sanders
- H.R.3421 introduced by Representative Pramila Jayapal, who represents Washington’s 7th district and is a member of the Democratic party
Alternative bills have also been proposed.
For example, Representative Pete Sessions, who represents the 17th district of Texas and is a member of the Republican party, proposed the Health Care Fairness for All Act (HR-3129). It would provide every American under age 65 years with an annual personal health credit that can be used for medical expenses and insurance premiums of their choice.
Florida representatives Greg Steube (17th district) and Kat Cammack (3rd district), who are members of the Republican party, have proposed the ACCESS Act (HR-5608). It aims to allow people with low incomes to open a tax-free Health Savings Account (HSA) that would be pre-funded with money to put toward insurance coverage.
As it stands, Medicare for All has received strong support and opposition from all sides.
Proponents argue it’s a basic human right and cite other countries with better outcomes and lower costs. Opponents say it’s too expensive and will decrease quality of care, particularly for those with specific conditions.
The COVID-19 pandemic has also added to the debate about how a single-payer healthcare system could affect worldwide disease outbreaks once they reach America.
In a 2022 study, researchers found that a Medicare-for-all system could have saved the United States
That said, it’s impossible to know exactly how Medicare for All would affect a scenario such as a pandemic socially, financially, or otherwise.
Ultimately, Medicare for All would have the biggest effects on Medicare beneficiaries by removing many of the Medicare options they are currently familiar with.
Medicare would no longer be available only to older adults. Instead, it would expand to include coverage for all Americans.
Though private Medicare options would no longer exist, all Medicare beneficiaries would be covered for their current services, plus more, with Medicare for All.