Beyond Bernie: Dems Unveil Sweeping Medicare-for-All Plan

Plus, Pelosi pooh-poohs Medicare for All, Green New Deal

House Dems’ New Medicare-for-All Plan More Sweeping Than Bernie Sanders’

House Democrats introduced a sweeping Medicare-for-all proposal Wednesday that would transform the U.S. health care system in just two years. Co-sponsored by more than 100 lawmakers, the plan would create a single-payer system that is more ambitious and more generous than other leading plans currently under consideration, including the one proposed by Sen. Bernie Sanders (I-VT).

“It’s time to put people’s health over profit," said Rep. Pramila Jayapal (D-WA), the bill’s lead sponsor. “We will be pushing it as hard as we can and as fast as we can. Enough nibbling around the edges. We really need to transform the system.”

Here’s what the plan would do:

  • Create a single-payer health-care system run by the government within two years
  • Provide medical, vision, dental and long-term care
  • Eliminate copays, premiums and deductibles
  • Put hospitals and nursing homes on fixed budgets
  • Pay doctors using a fee-for-service model. The existing Medicare system is trying to move away from that system.
  • Bar employers from offering competing plans
  • Sunset Medicare and Medicaid
  • Maintain the Veterans Affairs health system and the Indian Health Services

What’s missing: The plan does not include a cost estimate, nor does it indicate how the overhaul would be paid for. Jayapal has suggested that a wealth tax, mandatory employer contributions and savings generated by the new system could cover some or all of the costs.

How the plan compares: Jayapal’s plan is “significantly more generous than the single-payer plans run by America’s peer countries,” Vox’s Dylan Scott said.

The bottom line: House Speaker Nancy Pelosi has not endorsed the plan, and the bill has virtually no chance of passing this term. But the proposal suggests that Democrats continue to move left on health care, with an eye on radical changes that could take effect if the 2020 elections go their way.

Nancy Pelosi on Medicare for All: ‘How’s It Gonna Be Paid For?’

Rolling Stone has a new interview with House Speaker Nancy Pelosi. A few highlights from the interview, conducted last month by Tessa Stuart and Jann S. Wenner:

On the Green New Deal: “It’s an economic issue, and it is a moral issue to pass this planet on to future generations in the best possible way. As a Catholic, I believe that this is God’s creation, and we have a moral responsibility to be good stewards of it. … In any event, to reduce our dependence on fossil fuels, we have to put a price on coal, on carbon. It might be a carbon tax. We’ll see, but that’s the reason you have hearings and see what’s possible, what the market will be, what the private sector is willing to invest in, what is working in some other countries, and what we can do working together. … Now, in terms of the Green New Deal [as conceived], that goes beyond what our charge is. Our charge is about saving the planet. They have in there things like single-payer and ... what is it? Guaranteed income? … And then they have, I don’t know if it’s single-payer or Medicare for All. ... It’s kind of, like, a broader agenda. All good values, but nonetheless, not what we hope to achieve with this focused, determined, decision-making: You’re either for the planet or you are not. There is no ‘plan B’ for the planet.”

On Medicare for All: “Medicare for All is not as good a benefit as the Affordable Care Act. It doesn’t have catastrophic [coverage] — you have to go buy it. It doesn’t have dental. It’s not as good as the plans that you can buy under the Affordable Care Act. So I say to them, come in with your ideas, but understand that we’re either gonna have to improve Medicare — for all, including seniors — or else people are not gonna get what they think they’re gonna get. And by the way, how’s it gonna be paid for?

“Now, single-payer is a different thing. … Single-payer is just about who pays. It’s not about what the benefits are. That is, administratively, the simplest thing to do, but to convert to it? Thirty trillion dollars. Now, how do you pay for that? … All I want is the goal of every American having access to health care. You don’t get there by dismantling the Affordable Care Act.”

On income inequality: “The disparity in income in our country is an obscenity. And I’ve said to the members, ‘Everything that we put forth has to be in furtherance of reducing that disparity.’ Whether we’re talking about tax policy, whether we’re talking about investments in education and workforce development, whether we’re talking about infrastructure and how we do it in a way that increases paychecks, or how we do our oversight. We don’t begrudge anybody their success or their wealth. We just don’t like exploitation of the worker.”

On the GOP tax cuts: “The only way our economy is going to be really strong is if you have increased purchasing power of the middle class. It’s not about giving tax breaks to the wealthiest people in our country. That wasn’t supposed to happen. … It is shameful what [Republicans are] doing to the national debt, to enrich people. I mean, again, we don’t resent people their success and their wealth, but then they say, ‘Well, now we have to cover it by cutting Medicare and Medicaid and Social Security and the rest of that, because we have this national debt’?”

Read Pelosi’s full Rolling Stone interview.

What Americans Want to Do with Money Raised by Taxing the Rich

Voters support higher taxes on the rich. But what do they want done with the revenue those taxes would raise? A new Morning Consult-Politico poll asked about a range of options.

First, we should note that the poll found that 51 percent of voters strongly agree, and 23 percent somewhat agree, that “the wealthiest Americans should pay higher taxes.”

As for where the money from those higher taxes should go, the most popular choice was toward improving the health care system, followed closely by infrastructure improvements, reducing poverty and strengthening Social Security and Medicare. Reducing the federal budget deficit ranked fifth, while building a wall on the border with Mexico was the least popular option.

11 Million Taxpayers Hit by SALT Deduction Limit

Nearly 11 million tax filers will run into the $10,000 limit on state and local tax deductions that went into effect last year as part of the Republican tax overhaul, according to an audit released this week by the Treasury Inspector General for Tax Administration. The cap on the deduction, which hits residents of high-tax states such as New York, New Jersey and California particularly hard, will mean that taxpayers cannot deduct about $323 billion in state and local tax payments on their 2018 federal returns.

That doesn’t necessarily mean all 11 million filers will pay higher taxes, though, since other provisions of the law may make up for the lost deductions.

The SALT deduction cap remains controversial, and some blue state lawmakers continue to explore ways to limit or even eliminate it. President Trump said he was open to changing the limit in a meeting with New York Governor Andrew Cuomo earlier this month, but Congress is not expected to address the issue any time soon.

-->

How are we doing? Send your glowing praise, mild criticism and story tips to yrosenberg@thefiscaltimes.com. Or connect with us on Twitter: @yuvalrosenberg, @mdrainey and @TheFiscalTimes. And please tell your friends they can sign up here to get their own copy of this newsletter.

-->

How Old Is Old?

The average age of the U.S. population is rising as the Baby Boomers sail into their golden years, but a statistically older population may not be as problematic as some experts think. According to a new analysis from Eugene Steuerle and Damir Cosic of the Urban Institute, “traditional measures dramatically overstate aging problems.” Today, older citizens have “better health, greater capacity to work, and a more active lifestyle,” they write, which means that many of them will postpone the problems of the “truly old” for many years.

In addition to chronological age, Steuerle and Cosic argue, policymakers should consider measures that take into account ongoing changes in longevity and mortality rates. If seniors are living longer and in better health, then it makes sense to break down their population into subgroups that reflect these changes.

Along those lines, the authors analyzed the U.S. population using three different measures of “old” — 65 and older, those expected to live less than 15 more years and those expected to live less than 10 more years. The results (see the chart below) indicate that while the over-65 population will continue to grow for many years to come, as expected, the number of the “truly old” (those nearing their deaths) will stabilize at a much lower percentage of the population.

The analysis has implications for social welfare policy, including Medicare and Social Security.

The authors argue those programs were built using out-of-date assumptions about longevity, which may now distort efforts to aid the truly old. While they don’t explicitly advocate for an increase in the Social Security retirement age, Steuerle and Cosic say that, “If the retirement age in programs such as Social Security had been adjusted for longevity or improvements in life expectancy, Social Security would be running surpluses at existing tax rates not only today but even after the effects of baby boomers’ retirement had played out. Such surpluses could have been used to maintain higher benefits for those in need, those near poverty, and those with the chronic and long-term care needs that come in the last years of life.”

News

Views and Analysis