Should Democrats win control of the House and/or Senate in November, calls for a “Medicare for All” system are likely to grow louder. A variety of plans are being offered by lawmakers as well as think tanks. The proposals range from letting individuals and small groups buy into Medicare to legislation from Senator Bernie Sanders (I-VT) that would create a true "single-payer" system, eliminating employer-based coverage and enrolling all Americans in one, government-run plan.
A new analysis from the libertarian-leaning Mercatus Center at George Mason University in Virginia projects that Sanders’s “Medicare for All” plan would increase government health care spending by $32.6 trillion over 10 years. That estimate has garnered quite a bit of attention over the past few days. For those questioning the cost, the Urban Institute came up with the exact same number in 2016.
Here is what you need to know:
Support for such a proposal increases when framed as an option for anyone who wants it, but people who currently have other forms of coverage can keep the coverage they already have, both among the general public (75 percent) and among partisans (87 percent of Democrats, 74 percent of independents, and 64 percent of Republicans). This isn’t surprising, as our research has shown that the majority of employees view employer-sponsored insurance to be just as important as getting a salary. It is unclear how support would fare if these proposals became part of the larger public debate, as previous KFF polling has found the public’s attitudes can be quite malleable.
So what’s the likelihood of one of these proposals becoming law? My colleague Geoff Manville says it’s highly unlikely unless and until Democrats win the White House and full control of Congress, including a filibuster-proof 60-seat majority in the Senate. Still, employers and individuals need to consider how movement toward a single-payer system or a system that otherwise builds on Medicare and/or other public programs would affect private coverage and plans. Of course, this is only the beginning of this debate. Fasten your seatbelt – it’s going to be quite a ride!