September 15, 2017


In This Issue
Senate Continues Hearings on Market Stability with Goal of Introducing Bipartisan Legislation this Month
Graham-Cassidy Plan Introduced as Potentially the Final Attempt to Repeal and Replace the ACA
House and Senate Reintroduce Legislation to Change the ACA’s 30-Hour Workweek Rule to 40-Hours
Single Payer Bill is Introduced with Record 16 Co-Sponsors
It’s Bills, Bills, Bills – And Hearings – on this Week’s Podcast
Check Out the Newly Redesigned NAHU Website!
Register Now for Next Week’s Compliance Corner Webinar: Understanding Medicare Interactions with Group Insurance
Get Ready for Fall by Completing your Annual Marketplace Training
HUPAC Roundup
What We’re Reading
E-mail the Editor
Visit the NAHU Website
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Single Payer Bill is Introduced with Record 16 Co-Sponsors

On Wednesday, Senator Bernie Sanders (I-D-VT) introduced S. 1804, the “Medicare for All” bill, and was joined by 16 original co-sponsors from Democratic Senators Tammy Baldwin (WI), Richard Blumenthal (CT), Cory Booker (NJ), Al Franken (MN), Kirsten Gillibrand (NY), Kamala Harris (CA), Martin Heinrich (NM), Mazie Hirono (HI), Pat Leahy (VT), Ed Markey (MA), Jeff Merkley (OR), Brian Schatz (HI), Jeanne Shaheen (NH), Tom Udall (NM), Elizabeth Warren (MA) and Sheldon Whitehouse (RI). In addition to this bill, Senator Chris Murphy (D-CT) is planning to introduce similar legislation that would allow individuals to buy into Medicare, as a type of “public option” or a pared-down version of Sanders’ more dramatic overhauling of the existing healthcare system. NAHU has been a leading opponent of government-run healthcare and is deeply concerned about the damaging impact that these proposals could have on private-market coverage, and will continue to strongly oppose any efforts to implement a national public health insurance plan.


Sanders’ plan would expand Medicare into a single government insurance plan that would gradually provide comprehensive health insurance coverage, including inpatient and outpatient care and prescription drugs, to all U.S. residents. Existing individual and employer-based coverage would be replaced by the plan, although limited private coverage would be available for any services not covered by the plan. Many of the services covered by the plan would have no co-payments, with the cost of coverage paid for by a menu of possible tax changes, including employers paying an additional 7.5% in income taxes and individuals paying an additional 4%, as well as modifying the estate tax for the top 0.1% of income-earners. Medical providers would be reimbursed by the government and would need to sign annual participation agreements. If enacted into law, it would gradually be phased in over four years, with those under the age of 18 automatically enrolled in the first year and eligibility expanded every year until every resident becomes enrolled.


The proposal was met with much fanfare among liberal advocates, with about 30 organizations and unions endorsing the proposal along with the unprecedented 16 co-sponsors. Comparatively, Sanders’ bill from 2013 didn’t attract a single co-sponsor. However, both the Sanders and Murphy bills are largely symbolic and intended to be used for messaging by Democrats seeking far-reaching reforms, and it is unlikely that either of these bills will ever see a committee markup, much less be considered on the Senate floor. While support for single-payer and more government control in healthcare has grown among the far left in recent years, it remains highly unlikely that any legislation would pass on the federal level. This is especially true given the current control of both houses of Congress and President Trump’s promised veto of single-payer healthcare, calling it a “curse on the U.S.” Further, it is noteworthy that House Minority Leader Nancy Pelosi (D-CA) and Minority Whip Steny Hoyer (D-MD) said that they are not supporting Sanders’ plan, and will instead be focusing on current bipartisan efforts on market stability.


Many of your clients may have questions about the merits of single-payer or similar proposals, like the public option. We encourage you to share our single-payer infographic with your clients that visually depicts five major consequences of adopting single-payer healthcare and what could happen if it were to be adopted in the U.S., either at the state or federal level. We also encourage you to read through our public option position paper, adopted in September 2016. And if you are curious about the differences between single-payer and a public option, we encourage you to read our article on it from last October.  

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