Government affairs

Progressive Democrats in the House of Representatives introduced the “Medicare for All Act of 2019” (H.R. 1384) today. The measure, sponsored by the Progressive Caucus Co-Chair Rep. Pramila Jayapal (D-WA), would create a universal, single-payer health program that would replace most current forms of health insurance.

The bill would enroll all U.S. residents into the program, provide a more expansive set of benefits than the current Medicare program, and, over the course of a two-year transition, would restructure how health care providers such as hospitals and skilled-nursing facilities are paid.

Like Medicare, the measure would cover primary and preventive care, as well as inpatient and outpatient hospital services. However, it would also cover long-term care support services that are not covered by the current Medicare program, among other things.

“We mean a complete transformation of our health care system and we mean a system where there are no private insurance companies that provide these core benefits,” said Rep. Jayapal. “We mean universal care, everybody in, nobody out.”

The proposal would overhaul and replace much of the current system, and largely eliminate the private insurance industry by prohibiting the sale of duplicative health coverage or allowing employers to offer duplicative health coverage. To address this, the would designate a percentage of budget created to fund this program to support the employees affected by such a change. Notably, the only insurance programs not impacted by the measure would be the veterans health program and the Indian Health Service.

Crucially, the proposal does not cover exactly how the new health care program will be funded, whether it be from a reallocation of resources, increased taxes, or some other means.

The language and rollout of the bill has sparked some division among the Democratic Caucus, with some centrist and moderate Democrats unlikely to support it. Part of this is due to anticipated difficult re-election campaigns in many districts that went for the President in 2016. Others are focused on improving what we already have in the Affordable Care Act (Obamacare), which has grown increasingly more popular since its passage despite dozens of attempts by Congressional Republicans to repeal it.

The bill has been referred to the House committees on Budget and Rules where hearings are expected on it in the coming months.

NALC will review the bill’s impact to letter carriers and be sure to report on our findings in addition to keeping letter carriers up to date on any movement on the bill, but it is unlikely the legislation will progress through both the House and Senate, let alone be signed into law.