Medicare For All—What You Need to Know about Healthcare Reform During Election Season

Election season is upon us. As discussions on pertinent issues emerge to a national platform, it can be both exciting and confusing.

Healthcare reform is a complex topic. Debates between candidates—and the news stories that follow—often make it seem like major change is on the horizon.

This can create uncertainty, especially when trying to make sense of the facts (and the sensationalism that can surround them).

One topic that’s been discussed frequently in the past few months is Medicare for all. The term essentially describes medical coverage for everyone via a single payer system—the single payer being the federal government in this case.

“Single payer” refers to the entity that is paying the medical professionals and facilities for individuals’ healthcare claims (i.e. surgeries, office visits, etc.). There are many ways to build this type of system as other countries have shown, but the heart of this system is that the government provides medical coverage to everyone.

Medicare is currently only for those that are 65 and older with very few exceptions. Medicare for all would provide just that, regardless of age.

Medicare for all is a hot topic during election season. Political parties, pundits and news reporters will ramp up conversations, however, it’s unlikely that Medicare for All will have traction in the foreseeable future.

The information below is intended to help our readers better understand the terms and concepts being discussed frequently in the news.

Doesn’t the US already have a single payer system?  No, medical insurance in the US has multiple payers. Medicare, Medicaid (state run), Anthem, Aetna, Blue Shield, United Healthcare and more. All of these entities are paying medical professionals and facilities for individuals who are signed up for their insurance. For example, if a patient has Medicare, Medicare pays the doctor for health care claims. If an individual has United Healthcare, United Healthcare pays the doctor for health care claims.

Is a single payer system bad?  This is a question only you can answer for yourself. As such, this creates a divide between parties and individuals because there are many opposing views.

I’ve heard the terms single payer and Medicare for All used interchangeably. Do they mean the same thing?  Yes.

I’ve also heard the term “universal coverage.” Is that the same thing as Medicare for All?  It is not necessarily the same thing, but universal coverage would be the result of Medicare for All. Therefore, the two terms go hand-in hand. Universal coverage refers to every individual having health coverage. Here in the US, we currently do not have universal coverage as there are over 25 million Americans without health care coverage (i.e. medical insurance).

It is interesting to note that the Affordable Care Act individual mandate, no longer effective as of 2019, was an attempt to incentivize individuals to obtain health care coverage which would, in theory, result in “universal coverage.”

In conclusion, the topic of healthcare reform has been a point of discussion for quite some time. Currently, this initiative doesn’t have enough support in Congress to be passed into law—and it’s estimated to be a long road to get there with no viable proposal to pay for such a system.

 

 


Michelle Cammayo

About Michelle Cammayo

Michelle Cammayo has more than 13 years of Employee Benefits experience specializing in all lines of health and welfare benefits. Today, Michelle works closely with clients and partners to provide guidance in areas of the law including ERISA, HIPAA, COBRA, FMLA and PPACA. She also oversees the Compliance Department at Bolton & Company to ensure we are helping our clients manage and eliminate risk with regards to employee benefit compliance.

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