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Sanders Bill Would Expand Medicare During Covid-19 Crisis Instead of Costlier Plan to Prop Up Private Insurers

"No one in this country should be afraid to go to the doctor because of the cost—especially during a pandemic."

A healthcare worker takes a nasal swab sample from a resident to test for Covid-19 at the Abyssinian Baptist Church in the Harlem neighborhood of New York City on May 13, 2020.

A healthcare worker takes a nasal swab sample from a resident to test for Covid-19 at the Abyssinian Baptist Church in the Harlem neighborhood of New York City on May 13, 2020. (Photo: Angela Weiss/AFP via Getty Images)

Countering a proposal from Democratic congressional leadership to subsidize private health insurers, Sen. Bernie Sanders on Friday led a group of progressive lawmakers in introducing a competing bill to leverage the existing Medicare payment infrastructure to cover all out-of pocket health costs for every person in the country during the coronavirus pandemic.

"During this public health crisis, we must make sure that everyone in America is able to receive all of the medical care they need, regardless of their income, immigration status, or insurance coverage. No one in this country should be afraid to go to the doctor because of the cost—especially during a pandemic," Sanders (I-Vt.) said in a statement. "The American people deserve an emergency healthcare response that is simple, straightforward, comprehensive, and cost-effective."

"We should empower Medicare to pay all of the medical bills of the uninsured and the underinsured—including prescription drugs—for the duration of the coronavirus pandemic," he added. "When so many people in this country are struggling economically and terrified at the thought of becoming sick, the federal government has a responsibility to take the burden of healthcare costs off the backs of the American people. The legislation we are introducing today does just that."

The Health Care Emergency Guarantee Act (pdf), which Sanders first announced last month with Rep. Pramila Jayapal (D-Wash.), is co-sponsored by Sens. Kirsten Gillibrand (D-N.Y.), Edward Markey (D-Mass.), Elizabeth Warren (D-Mass.), Cory Booker (D-N.J.), Jeff Merkley (D-Ore.), and Kamala Harris (D-Calif.).

The bill—which would also immediately halt all medical debt collection, limit prescription drug prices, and prohibit private insurance companies from decreasing coverage—comes as unemployment claims since mid-March topped 36 million and an estimated 16.2 million people have lost their employer-based health insurance.

"The Covid-19 pandemic has placed Americans under tremendous stress," said Harris. "On top of wondering how they will pay rent and put food on the table, paying for medical treatment if they get sick should not be another worry for families."

Sanders' bill offers an alternative to a healthcare provision included in the $3 trillion Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act that House Democratic leadership introduced Tuesday. As David Dayen wrote Wednesday for The American Prospect, "To deal with the uninsured, the HEROES Act subsidizes COBRA, the costliest possible way to maintain insurance rates, really a bailout of that industry."

COBRA allows laid-off and furloughed workers to pay to temporarily stay on their employer-provided private health insurance plan. Since that proposal from House Democratic leadership was first reported in April, Sanders has argued that his legislation empowering Medicare to cover expenses for the uninsured is a "better way to guarantee that everyone in America gets all the healthcare they need, without cost, for the duration of the pandemic."

Recent polling (pdf) conducted by Data for Progress indicates a large majority of Americans agree with Sanders. While 55% of voters across the political spectrum said they supported covering the cost of insurance premiums through COBRA, 73% backed using Medicare to cover all out-of-pocket expenses during the Covid-19 crisis.

When pollsters told voters that Sanders' plan—which would cover millions more people—would cost $150 billion over four months compared with $157 billion for the COBRA proposal, 61% said they would prefer fully funding Medicare while only 14% preferred Democrats' measure to subsidize private insurance and 25% were undecided.

In addition to being backed by over a dozen House Democrats, the Health Care Emergency Guarantee Act is endorsed by 32 national organizations and unions including the Association of Flight Attendants-CWA, National Nurses United (NNU), Service Employees International Union (SEIU), Indivisible, MoveOn.Org, People's Action, Public Citizen, Social Security Works, Sunrise Movement, United We Dream, Democratic Socialists of America, Economic Policy Institute, and Medicare for All Now.

"Registered nurses are on the frontlines of the Covid-19 pandemic, and we know from our experiences at the bedside that people who are uninsured or underinsured are foregoing the healthcare they need because they can't afford it," said NNU executive director Bonnie Castillo, RN. "We cannot adequately respond to the Covid-19 crisis unless we guarantee healthcare to every person living in our country."

The debate over how best to cover the costs of care for the uninsured and underinsured highlights broader issues with the existing U.S. healthcare system. Noting that health insurance in the United States is tied to employment and millions of people are losing jobs because of the pandemic, Public Citizen president Robert Weissman said Friday that Sanders and Jayapal's bill "responds to this outrage with common sense and compassion."

Sanders and Jayapal have led the charge in their respective chambers to address the inadequacies of the current system by shifting to a single-payer scheme dubbed Medicare for All. Jayapal on Friday put the fight for Covid-19 relief into the broader context of the fight for guaranteeing healthcare as a human right to everyone.

"Everyone in America should have guaranteed access to healthcare, especially during a national emergency."
—Rep. Pramila Jayapal
"Our broken healthcare system is failing to protect millions of Americans from the coronavirus pandemic. Now more than ever, we need to take bold action to prevent more Americans from getting sick or dying," she said. "Everyone in America should have guaranteed access to healthcare, especially during a national emergency."

Jayapal is also sponsoring the Medicare Crisis Program Act, introduced two weeks ago with Rep. Joe Kennedy (D-Mass.). That legislation would "dramatically expand" Medicare and Medicaid eligibility, cap out-of-pocket costs for Medicare enrollees, and require all health insurers to fully cover Covid-19 care, even for patients who ultimately show a negative test.

In an op-ed for Common Dreams on Friday, Diane Archer of Just Care USA compared Jayapal and Kennedy's bill will the COBRA plan, arguing that "if the goal is to help unemployed workers, the COBRA proposal makes little sense. Without a job, most unemployed workers will struggle to afford out-of-pocket costs for their care. Many will be forced to forgo needed care. And, it offers no benefit to unemployed workers who did not previously have health insurance through their employer."

"There's one group that benefits handsomely from the COBRA proposal: The health insurance industry," Archer added. "Focus should be on guaranteeing Americans access to care, not on subsidizing a profitable industry."

Physicians for a National Health Program president Dr. Adam Gaffney, in a statement Friday, similarly compared the Health Care Emergency Guarantee Act to the COBRA plan. 

"COBRA subsidizes prop up the health insurance industry while leaving families in the lurch," he said. "In the long run, we need Medicare for All to provide full health protections for Americans. But the Health Care Emergency Guarantee Act could ensure protection for American families today."

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