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New Democratic proposal offers a middle ground on Medicare expansion

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(CNN)Two House Democrats reintroduced health care overhaul legislation Wednesday that would provide universal coverage but stop far short of the sweeping “Medicare for All” plan embraced by several 2020 presidential candidates.

The bill would allow employers to continue to offer gold-level benefit plans, a key distinction from Medicare for All, which would get rid of private insurance.
In a phone call with reporters on Wednesday, DeLauro argued it was important for people to be able to make their own choice about health benefits, “and not one day be stripped of what they do know.”
    “We were really trying to meet that need of people to make an informed choice of where they want to be,” she said.
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    Schakowsky suggested a full transition to single-payer could come at a later date, but that it might not be the best starting point. “It makes the transition to universal health care much easier to build on what we have now,” she said.
    It’s just one of several competing bills that Democrats have brought forward in recent months to reform the nation’s health care system — and just as the landmark Affordable Care Act comes under renewed legal assault from the Trump administration.
    Reps. Pramila Jayapal and Debbie Dingell have introduced a more generous version of Vermont Sen. Bernie Sanders’ Medicare for All bill in the House, and it has won support from 108 Democratic cosponsors. That bill would include a two-year transition period, at the end of which every American would receive comprehensive coverage under the same plan.
    Medicare for America differs from Jayapal’s plan in a notable respect: It comes with built-in ways to pay for the program’s cost.
    DeLauro and Schakowsky would pull together revenue by increasing the Medicare payroll tax, hiking excise taxes on tobacco, beer, wine, liquor and sugary drinks, scrapping the 2017 GOP tax cuts and slapping a 5% surtax on individuals with an adjusted gross income above $500,000.
    In the phone call on Wednesday, DeLauro brushed off concerns about divides within the Democratic Party and said she didn’t view anything about her proposal as adversarial.
    “You have to put this in context. It wasn’t that long ago where the debate was whether or not we were going to be able to cover people with a pre-existing condition,” she said of the Affordable Care Act debate. “It is really rather remarkable that what we are doing, from whatever iteration you are from, is discussing the issue of universal health care.”
    “There may be others who see this as a divide,” she added. “I don’t see it as a divide. I hope that it is a healthy, robust debate about one of the most pressing issues on the mind of the public.”
    With the presidential campaign kicking into gear after a midterm election dominated by health care, the issue will take center stage. Frontrunner Joe Biden is at odds with Sanders’ Medicare for All rallying cry, recently calling instead for a more modest Medicare public option.
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    And Beto O’Rourke has signaled his support for DeLauro’s Medicare for America plan, touting the option to retain private insurance.
    “What it says is, if you like your employer-sponsored insurance, you like the network that you’re in, you like the doctors that you can see, you’re happy with that, you can keep it,” he said last month in New Hampshire. “If you do not like your employer-based insurance and want to enroll in Medicare, you can. If you have no insurance whatsoever or if you are under-insured today, you can enroll in Medicare as well.”
    Medicare for America also has backing from the Center for American Progress, a left-leaning think tank.
    “Consumers who have private insurance through their employer, many of them like the private insurance through their employer,” Neera Tanden, president and CEO of the center, told reporters during the phone call with Schakowsky and DeLauro on Wednesday. “The beauty of this legislation is that it maintains that choice.”
    Tanden also pushed back on single-payer plans that would eliminate private insurance — “We think there are legitimate arguments for alternative paths, but we also believe that at the heart of the health care system, the United States has always maintained some degree of choice for consumers,” she said.
    Democrats in Congress are grappling over how to handle the issue amid growing support for sweeping change from the progressive grassroots. On Tuesday, the House Rules Committee held the first ever congressional hearing on Medicare for All.
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    The hearing was cordial; lawmakers and witnesses mostly stuck to the policy effects of Jayapal’s plan. But progressive activist Ady Barkan, who is dying of ALS, also lit a fire under Democrats’ seats, calling for swift action.
    “Some people argue that although Medicare for All is a great idea, we need to move slowly to get there,” Barkan said in his opening statement. “But I needed Medicare for All yesterday. Millions of people need it today. The time to pass this law is now.”
    In order to pass their desired health care overhaul, Democrats would have to overcome internal disagreements in the House, win back the Senate, and potentially end the Senate filibuster, which requires 60 votes to approve legislation. They could also try to pass the bill through budget reconciliation, which requires only a simple majority of 51 votes but can limit the subjects a bill can address. Republicans used reconciliation in 2017 to attempt to repeal the Affordable Care Act, but they failed to win enough support for the measure within their own ranks.
    A bipartisan effort to expand Medicare, of course, is out of the question.
      Oklahoma Rep. Tom Cole, the top Republican on the committee, said Jayapal’s bill was a “socialist proposal that threatens freedom” and emphasized that Republicans have a range of fundamental problems with the concept, such as its provision to allow federal dollars to pay for abortions.
      “What Democrats are proposing today would completely change America’s health care system, and not in my view, for the better,” Cole said.

      Read more: https://www.cnn.com/2019/05/01/politics/house-democrats-medicare-for-america/index.html

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