House Progressives Unveil Single-Payer Health Bill

More than 100 House Democrats laid down an aggressive marker Wednesday for what "Medicare for all" means to them ahead of the 2020 campaign, filing a bill that would replace private insurance with a nationwide program that would cover all Americans.

The lead sponsor, Rep. Pramila Jayapal of Washington, says Americans are paying through the nose in the form of premiums and deductibles but seeing poor health outcomes, while others must beg to pay for needed services.

"GoFundMe is becoming one of the most popular insurance plans in the country," Ms. Jayapal told a vocal crowd of supporters at a rollout near the Capitol.

The congresswoman wants to dole out government insurance cards within two years, faster than the four-year runway under Sen. Bernard Sanders's prominent single-payer bill.

The program would cover a generous suite of benefits, from hospital services and mental health care to prescription drugs with no premiums, copays or deductibles. It's not clear how those costs would be offset.

Alternate health plans would be barred from covering the same services, leaving them to insure supplemental items such as cosmetic surgery.

While it has no chance of becoming law this Congress, the bill suggests a wide swath of the House Democratic majority is willing to back the most ambitious of plans to fill gaps left by Obamacare, their major overhaul from 2010.

Nearly 30 million Americans are still uninsured, though Democrats seeking to build on mid-term electoral gains or retake the White House next year are split on how far they should go in extending taxpayer-funded options.

House Democratic leaders have focused on defending the Affordable Care Act or exploring single-payer in theory, while Sen. Sherrod Brown of Ohio, a potential 2020 presidential contender, says the most effective approach currently is to extend Medicare to people age 50 and above.

President Trump, meanwhile, is relishing the chance to nudge aside his failure to repeal and replace Obamacare in 2017 and attack a government-run insurance program as part of a Democratic shift toward "socialism."

Ms. Jayapal rejected claims her bill amounted to a government takeover of the system.

"We're still using the existing provider network," she said. "The only thing we're doing to changing how we pay for it."

How the federal government would fund those payments is not clear.

Ms. Jayapal did mention a tax on the wealthy as an option to pay for some of the cost, though she mainly stressed potential savers, such as a reduction in administrative costs or an expansion of preventive services to avoid costlier health bills down the road.

Analyses of similar plans said it could cost north of $30 trillion over a 10-year budget window, which likely would mean higher taxes.

Supporters say any burden would displace the premiums and out-of-pocket payments Americans are coughing up to private industry today.

The push for a single-payer program has prominent supporters, including Mr. Sanders and Sens. Elizabeth Warren, Kamala Harris and Cory Booker — all 2020 presidential contenders.

Yet it also has vocal, well-funded opponents.

A coalition of insurers, hospitals and pharmaceutical groups is lobbying hard to keep government-centered health care out of the conversation on Capitol Hill, and Republicans who control the Senate will reject House Democrats' ideas.

Recent polls suggest a majority of Americans like the concept of a single-payer program, though support plummets when tradeoffs, such as potential wait times or limits on services, are floated.

"When Americans see Democrats' true, frightening government takeover of health care — banning good health care plans at work, jeopardizing Medicare for seniors, and doubling everyone's taxes — voters will reject it," said Rep. Kevin Brady of Texas, the top Republican on the House Ways and Means Committee.

Republicans say Congress should work within the current system in which more than 150 million are insured by private insurers through their jobs, while the needy or seniors tap into public programs. Mr. Trump has tried to expand the reach of private options outside of Obamacare, so that young and healthy people can pay less than what the 2010 law provides.

Single-payer proponents say the private companies are part of the problem, however, because they weigh payment for care against earnings.

Vocal supporters who gathered for the bill's rollout shouted "shame" and "parasites" at the mention of insurers' profits.

Major labor unions, including National Nurses United and the American Federation of Teachers, lined up behind the bill and gave its sponsors a rock star's welcome, cheering and whooping after every argument from the speakers.

Ms. Jayapal said if the U.S. can end slavery, give women the vote and put a man on the moon, "then by God, we can do universal health care."