Capitol Alert

Bernie Sanders, Kamala Harris embrace details of ‘Medicare-for-all’ – including tax hikes

California’s junior Sen. Kamala Harris on Wednesday backed Vermont Sen. Bernie Sanders in making an impassioned call for a national, taxpayer-funded health care system that would extend Medicare to all Americans and eliminate the need for private insurance companies, a move seen as symbolic for Democrats positioning themselves as the leaders of a party that is moving further left.

In announcing legislation to create what he called a universal, “Medicare-for-all” health care system, Sanders launched a nationwide campaign for a massive reorganization of the way in which health care is financed and delivered.

“Today we begin the long and difficult struggle to end the international disgrace of the United States, our great nation, being the only major country on Earth not to guarantee health care to all of our people,” Sanders said. “The function of a rational health care system is to provide quality care to all, in a cost-efficient way and not to continue a system which allows insurance companies and drug companies to make hundreds of billions in profits each year.”

The estimated cost of a new system is $1.38 trillion per year, according to Sanders’ plan. Current health care spending is roughly $3.2 trillion per year, according to the Centers for Medicare and Medicaid. Sanders offered options to pay for his legislation, including tax increases on employers and household income, reducing tax deductions on households earning more than $250,000 per year and establishing a “wealth tax” on top income earners. Eliminating insurance companies would also save money by reducing corporate taxes and administrative costs, Sanders said.

Harris, the first Senate Democrat to announce her plan to co-sponsor the bill, called the “Medicare For All Act of 2017,” said she supports it because it’s “simply the right thing to do.” Sanders and Harris argued it would reduce health care costs over the long-term, amounting to a significant “return on investment” for Americans.

“This should not be thought of as a partisan issue,” Harris said, echoing comments she made in Oakland Aug. 30. “Cancer, diabetes, high blood pressure affects folks around our country regardless if they’re in a red state or a blue state...let’s give taxpayers of the United States a better return on investment, that means Medicare-for-all.”

Sanders and his Democratic supporters’ long-shot bid stands little chance of being taken up by the Republican-controlled Congress, but those seen as potential presidential contenders in 2020 – including Sanders and Harris, as well as Sens. Cory Booker of New Jersey and Elizabeth Warren of Massachusetts – could benefit from being outspoken on what Sanders has coined “Medicare-for-all,” said RoseAnn DeMoro, executive director of the California Nurses Association and National Nurses United, among the bill’s most vocal supporters. Like abortion rights, she called it a “litmus test” for the Democratic Party.

“This is a populist movement,” DeMoro said in an interview. “Bernie’s campaign gave voice to it at a grand scale. Unfortunately, many Democrats somehow are missing it...Democrats who don’t support single-payer need to step aside and let the new progressive energy bubble up.”

Veteran Democrats in Congress, including Sen. Dianne Feinstein and House Minority Leader Nancy Pelosi have balked at establishing a universal, government-financed health care system known as single-payer, saying instead the focus should be on improving the Affordable Care Act. Republicans have decried the plan as a government takeover of health care, and the National Republican Congressional Committee calls it a “socialist pipe dream,” saying on Twitter that Sanders “has taken over the Democratic Party and House Democrats are being pulled left with him.”

Rep. Ami Bera, D-Elk Grove, said Democrats should work with Republicans to improve health care following their failed attempts to repeal and replace Obamacare.

“I support the goal of universal coverage, but Americans need solutions, not broad frameworks,” Bera said in an email. “That’s why I’m focused on improving the Affordable Care Act and reducing the cost of health care.”

Nurses spoke in favor of Sanders’ bill Wednesday.

“Because of high deductibles and out of pocket expenses, we have tragic cases of people who simply do not have the money to pay for the treatment they need,” said Melissa Johnson-Camacho, a Sacramento-area nurse. “This system is killing too many of my patients – I say ‘No more.’ Let’s put an end to this immoral system that puts profits before patients’ care is a human right and we are going to make it happen.”

The move comes amid a push by some Democrats in the California Legislature to pass a universal, single-payer health care bill for all of California. Assembly Speaker Anthony Rendon shelved the bill earlier this year, citing the lack of a clear financing plan to pay for the $400-billion reorganization.

DeMoro, who has criticized Rendon on Twitter, said the nurses are targeting him and other Assembly Democrats in their home districts. Nurses and universal health care supporters have launched an aggressive campaign urging public support for Senate Bill 562, the single-payer bill from state Sens. Ricardo Lara, D-Bell Gardens, and Toni Atkins, D-San Diego. The campaigns include die-ins and door-knocking this week, from Santa Ana to Santa Barbara to Bakersfield to Santa Rosa.

“The state bill is achievable right now,” DeMoro said. “What’s blocking it is the Democrats in the Assembly...if we can move some of them out of the way, I think we can achieve a Medicare-for-all single payer system in California that sets the national narrative.”

Steve Maviglio, a California Democratic strategist, called the idea of single-payer a “pipe dream” and said Congress, as well as the state Legislature, should focus on improving the Affordable Care Act.

“Because of the pressure of vocal activists, most of the Democratic presidential wannabes feel the need to throw them a bone, but if you ask them how it’s actually going to get done, there’s scant details,” Maviglio said. “It raises false hopes of millions of people. I think that’s just morally cruel. All this energy should go to fighting for what we have and making sure it works.”

He said Rendon was “rightfully looking out for his members” when he announced the Assembly would not hold a hearing on the state bill. “He has to protect his members in swing districts where this can be pretty lethal,” Maviglio said.

Sanders’ bill would establish a federally administered national health insurance program to be implemented over a four-year period, slowly lowering the age of those eligible for Medicare. During the first year, the eligibility age would be lowered to 55, while Medicare Parts A, B and D deductibles would be eliminated. The age of eligibility age would be lowered to 45 on the second year, 35 on the third year and by the fourth year, a universal Medicare system would be in place and everyone who lives in the U.S. would receive a Medicare card.

Sanders says his proposal would be more efficient, simpler and less expensive. There would be one insurance plan for U.S. residents, with the government acting as the “single-payer,” “instead of wasting hundreds of billions of dollars trying to administer an enormously complicated system of hundreds of separate insurance plans,” said a memo on Sanders’ bill. The plan would eliminate health insurance premiums, co-pays, deductibles or other out-of-pocket costs.

“Instead of writing a big check to private insurance companies, most Americans and businesses would be paying a much smaller percentage of their income to fund Medicare-for-all,” the memo said. Employer-sponsored coverage would disappear, and the 28 million uninsured Americans today would be covered under the government-run system.

The existing health care delivery system would remain in place, and patients would be able to choose their doctors and hospitals. It also seeks to lower the cost of prescription drugs by enlisting the government to take over negotiating prices with pharmaceutical companies. “This legislation will give the federal government the ability to stand up to drug companies and negotiate fair prices for the American people,” the memo said. The federal government would be able to limit co-payments for prescriptions to encourage the use of generic drugs.

It would cover inpatient, outpatient and emergency care, primary and preventive services, prescription drugs and medical devices, mental health and substance abuse services, comprehensive maternity care and abortions, pediatric care, dental, audiology, vision and more. States would be able to boost health care benefits for their residents.