Voters understand Medicare-for-all better than Bernie does | xpostfactoid

Voters understand Medicare-for-all better than Bernie does | xpostfactoid: If Democrats get a chance to move on healthcare reform, voters expect...Medicare for America
by Andrew Sprung

Be that as it may, respondents' expectations point toward a reformed system in which Medicare is available to all, while employer-sponsored insurance and private individual market insurance continue to exist alongside it. The public plan covers most but not all of the population, and it includes deductibles and copays.

That's an accurate description of the Medicare for America bill introduced in the House by Reps Rosa DeLauro and Jan Schakowsky. That bill would allow anyone to buy into a revamped, comprehensive "Medicare" program on a sliding scale requiring premiums ranging from 0-8% of income ($0 for anyone with income up to twice the Federal Poverty Level). They could also buy into tightly regulated private alternatives, and employers could continue to offer insurance, required to meet a standard close to the current employer norm. People with incomes over 200% FPL would have to pay coinsurance for many services. It's true that deductibles have been eliminated in the bill's latest version, but annual out-of-pocket maximums can go as high as $3,500 individual/$5,000 family.

This is not to suggest that Kaiser survey respondents are any more familiar with the Medicare for America bill than they are with the Medicare for All bills (doubtless they are less so).  But a lot of presidential candidates are talking up Medicare buy-ins, and by whatever osmosis, the majority expectation for a Democratic administration/Congress (who else would try to put over a national health system?) lands quite close to the Medicare for America design. Perhaps that's not so surprising, as Medicare for America is only the latest iteration of a basic healthcare reform architecture that predates the Affordable Care Act.

Maybe the takeaway from the Kaiser survey has been inverted. The point isn't that voters misunderstand the Medicare for All bills introduced by Sanders in the Senate and Jayapal in the House -- but rather that the particulars of those bills haven't registered because voters don't consider them realistic or desirable.

These survey responses reflect reality. Democrats are not going to pass legislation that offers more comprehensive coverage than any national health plan on the planet. They're not going to pass a bill that requires more than doubling federal tax revenue. They're not going wipe out the private health insurance industry in 2-4 years, and they're not going to subject providers exclusively to Medicare payment rates within the same time period. They are not going to take on every segment of the mammoth U.S. healthcare industry and concede nothing to any of them.