Implications of “Medicare for All” and “Public Plan” Strategies: New Brief and Interactive Tool Summarize Legislative Proposals and Key Issues

The idea of expanding the role of government programs such as Medicare and Medicaid has received renewed attention on Capitol Hill and on the campaign trail this year as policymakers consider ways to expand health insurance coverage and moderate health care costs.

Lawmakers have introduced eight such proposals in the current Congress. They range from bills that would create a new, all-encompassing national health insurance program (sometimes called “Medicare-for-All”) to less sweeping measures that would create a new public plan option to supplement private sources of coverage and existing public programs. A new issue brief from KFF (the Kaiser Family Foundation) summarizes key features of these proposals and highlights their similarities and differences. It also compares the policy implications and tradeoffs involved in these proposals, and examines the plans’ potential implications for consumers, health care providers and payers. An accompanying interactive tool allows users to compare key elements of the proposals in a side-by-side format.

Although unlikely to advance during the remainder of the current session, the proposals could serve as prototypes for legislation in a future Congress. They illustrate the range of options that may emerge in the coming years. Greatly simplified, the current bills fall into four general categories:

• Two proposals would create Medicare-For-All, a single national health insurance program for all U.S. residents  (Senator Sanders, S. 1804; Rep. Ellison, H.R. 676)
• Three proposals would create a  new public plan option, based on Medicare, that would be offered to individuals and some or all employers through the ACA marketplace  (Rep. Schakowsky, H.R. 635/Sen. Whitehouse, S.194; Sen. Bennett, S. 1970/Rep. Higgins, H.R. 4094; Sen. Merkley, S. 2708/Rep. Richmond, H.R. 6117)
• Two proposals would create a  Medicare buy-in option for older individuals not yet eligible for the current Medicare program (Sen. Stabenow, S. 1742; Rep. Higgins, H.R. 3748); and
• One proposal would create a Medicaid buy-in option that states can elect to offer to individuals through the ACA marketplace. (Sen Schatz S. 2001 and Rep. Lujan, H.R. 4129)