Bill Overview
Title: Medicare for America Act of 2019
Description: 2019 [ sic ] This bill establishes several health insurance programs and otherwise modifies certain requirements relating to health care coverage, costs, and services. In particular, the bill establishes a national health insurance program to be administered by the Department of Health and Human Services (HHS). Among other requirements, the program must (1) cover all U.S. residents; (2) cover specified items and services, including hospital services, prescription drugs, dental services, and home- and community-based long-term care; and (3) be fully implemented in 2026. HHS must also offer a transitional public health option that provides certain minimum coverage through health insurance exchanges in 2024 and 2025. The bill also makes a series of other changes to health care and tax provisions. For example, the bill (1) allows federal funds to be used for abortions; (2) sunsets a specified tax reform law that, among other things, repealed the penalty for failing to maintain minimum essential health coverage; and (3) prohibits excessive prices for prescription drugs and medical devices, as determined by a newly established federal regulatory board.
Sponsors: Rep. DeLauro, Rosa L. [D-CT-3]
Target Audience
Population: All United States residents
Estimated Size: 333000000
- The bill aims to establish a national health insurance program covering all U.S. residents, therefore all U.S. residents will be impacted.
- The program includes coverage for hospital services, prescription drugs, dental services, and long-term care, impacting all residents who use these services.
- Inclusion of certain taxes and regulation of drug prices will impact all U.S. residents by potentially altering costs.
- Changes to federal tax laws concerning health care will affect the financial situation of residents.
- The transition plan for 2024-2025 implies a gradual impact, reaching full scale by 2026.
Reasoning
- The Medicare for America Act aims to cover all U.S. residents, affecting individuals of different demographics and socioeconomic backgrounds.
- Given the comprehensive coverage of services such as hospital care, prescription drugs, and dental services, the policy will especially impact those who currently face high medical costs or lack adequate coverage.
- The impact will vary depending on individuals' current health insurance status, financial situation, and health needs.
- Since the policy includes provisions for funding and cost regulation, it considers economic sustainability, but the budgetary constraints could affect program effectiveness across varied populations
- People with existing comprehensive insurance might experience minimal change, whereas uninsured individuals will see a significant increase in wellbeing.
- The vast budget suggests wide transformation possibilities, yet costs will have to be managed carefully to prevent overspending.
- A mix of high, medium, low, and no impact scenarios will provide a realistic view of the range of experiences under the policy.
Simulated Interviews
Restaurant Manager (Austin, TX)
Age: 35 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 20.0 years
Commonness: 8/20
Statement of Opinion:
- I can't afford insurance right now, so access to comprehensive coverage would be life-changing.
- Having dental and prescription drug coverage is important for my kids.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 4 |
| Year 3 | 8 | 4 |
| Year 5 | 8 | 3 |
| Year 10 | 9 | 3 |
| Year 20 | 9 | 2 |
Truck Driver (Rural Kentucky)
Age: 50 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 15.0 years
Commonness: 10/20
Statement of Opinion:
- I pay a lot out of pocket for specialized treatment, so I'm curious how this will help manage costs.
- The long-term care options could be useful as I age.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 9 | 5 |
| Year 20 | 8 | 4 |
Freelance Graphic Designer (San Francisco, CA)
Age: 29 | Gender: other
Wellbeing Before Policy: 5
Duration of Impact: 20.0 years
Commonness: 7/20
Statement of Opinion:
- Comprehensive coverage would ease a lot of my financial stress.
- I worry about balancing taxes, but health security is worth it.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 8 | 5 |
| Year 3 | 8 | 4 |
| Year 5 | 9 | 4 |
| Year 10 | 9 | 3 |
| Year 20 | 9 | 3 |
Retired (Chicago, IL)
Age: 65 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 10.0 years
Commonness: 12/20
Statement of Opinion:
- I'm glad there might be additional dental coverage and lower drug prices.
- I hope the changes don't complicate my current plans.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 8 | 7 |
| Year 10 | 8 | 6 |
| Year 20 | 8 | 6 |
Software Engineer (Los Angeles, CA)
Age: 40 | Gender: male
Wellbeing Before Policy: 8
Duration of Impact: 0.0 years
Commonness: 16/20
Statement of Opinion:
- I don't expect much change as I already have good coverage, but I'm in favor of helping those in need.
- Worried about how this might affect taxes.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 8 | 8 |
| Year 5 | 8 | 8 |
| Year 10 | 8 | 8 |
| Year 20 | 7 | 8 |
Teacher (New York, NY)
Age: 45 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 15.0 years
Commonness: 14/20
Statement of Opinion:
- This could help with unexpected medical expenses, but my union has good benefits.
- Hope this doesn't lead to higher taxes.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 8 | 7 |
| Year 10 | 8 | 7 |
| Year 20 | 8 | 6 |
College Student (Orlando, FL)
Age: 22 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 8.0 years
Commonness: 11/20
Statement of Opinion:
- Access to mental health services would be very beneficial.
- Worried about how this will affect future costs post-graduation.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 8 | 6 |
| Year 3 | 8 | 5 |
| Year 5 | 9 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 8 | 4 |
Factory Worker (Detroit, MI)
Age: 60 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 15.0 years
Commonness: 10/20
Statement of Opinion:
- I worry about the transition to retiree coverage, so this could help stabilize things.
- Sounds promising if prescription costs can be driven down.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 7 | 5 |
Retired (Phoenix, AZ)
Age: 70 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 13/20
Statement of Opinion:
- If this policy helps with medication costs, that's a huge relief.
- I hope it integrates well with existing Medicare options.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 6 | 4 |
| Year 20 | 6 | 4 |
Barista (Seattle, WA)
Age: 28 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 20.0 years
Commonness: 9/20
Statement of Opinion:
- I often avoid going to the doctor because I can't afford it, so this would greatly improve my wellbeing.
- Access to dental care is also a big plus.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 8 | 4 |
| Year 10 | 9 | 4 |
| Year 20 | 9 | 3 |
Cost Estimates
Year 1: $1000000000000 (Low: $900000000000, High: $1100000000000)
Year 2: $1100000000000 (Low: $1000000000000, High: $1200000000000)
Year 3: $1200000000000 (Low: $1100000000000, High: $1300000000000)
Year 5: $1400000000000 (Low: $1300000000000, High: $1500000000000)
Year 10: $1600000000000 (Low: $1500000000000, High: $1700000000000)
Year 100: $2500000000000 (Low: $2300000000000, High: $2700000000000)
Key Considerations
- The bill will significantly alter the healthcare landscape in the U.S., transitioning large numbers from private to public coverage.
- Policy implementation hinges on strong administrative capability and coordination among healthcare providers.
- Healthcare cost regulation and price control pose complex challenges and potential legal hurdles.
- Achieving sustainability of funding and public acceptance are critical for long-term success.