Conyers Reintroduces "Expanded & Improved Medicare For All" Bill

February 14, 2011 | By The Office of Congressman John Conyers, Jr.
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While the reform law that was passed by Congress is the first national commitment to providing meaningful access to healthcare, I believe that a single-payer, universal healthcare system is the only way we can truly reshape our broken healthcare system.  Here is my proposal:

H.R. 676, “The Expanded & Improved Medicare For All Act,” Introduced by Rep. John Conyers, Jr.

Brief Summary of Legislation

HR 676 establishes a unique American universal health insurance program with single payer financing.  The bill would create a publicly financed, privately delivered health care system that improves and expands the already existing Medicare program to all U.S. residents, and all residents living in U.S. territories. The goal of the legislation is to ensure that all Americans will have access, guaranteed by law, to the highest quality and most cost effective health care services regardless of their employment, income or health care status. In short, health care becomes a fundamental human right, with no financial barriers or financial harm resulting from seeking care. With 51 million uninsured Americans, and another 30 million who are underinsured, the time has come to change our inefficient and costly fragmented non-system of health care. The current for-profit health care system in the U.S. is not financially sustainable over the long run, hence the need for a unique non-profit universal single payer health care system.

Who is Eligible

Every person living or visiting in the United States and the U.S. Territories would receive a “Medicare For All Card” and ID number once they enroll at the appropriate location. Social Security numbers may not be used when assigning ID cards.
                                              
Health Care Services Covered

This program will cover all medically necessary services, including primary care, medically approved diet and nutrition services, inpatient care, outpatient care, emergency care, prescription drugs, durable medical equipment, hearing services, long term care, palliative care, podiatric care, mental health services, dentistry, oral surgery, eye care, chiropractic, and substance abuse treatment. Patients have their choice of physicians, providers, hospitals, clinics, and practices. There are no co-pays or deductibles allowed under this act.

Conversion To A Non-Profit Health Care System

Doctors, hospitals, and clinics will continue to operate as privately entities.  However, they will be unable to issue stock.  Private health insurers shall be prohibited under this act from selling coverage that duplicates the benefits of the Improved Medicare For All program.  Exceptions to this rule include coverage for cosmetic surgery, and other medically unnecessary treatments. Those workers who are displaced as the result of the transition to a non-profit health care system will be the first to be hired and retrained under this act. Furthermore, workers would receive their same salary for up to two years, and would then be eligible for unemployment benefits.  The conversion to a not-for-profit health care system will take place as soon as possible, but not to exceed a 15 year period, through the sale of U.S. treasury bonds.
 
Cost Containment Provisions/Reimbursement

The Improved Medicare For All program will negotiate reimbursement rates annually with physicians, allow for global budgets (monthly lump sums for operating expenses) for hospitals, and negotiate prices for prescription drugs, medical supplies and equipment. A “Medicare For All Trust Fund” will be established to ensure a dedicated stream of funding.  An annual Congressional appropriation is also authorized to ensure optimal levels of funding for the program, in particular, to ensure the requisite number of physicians and nurses need in the health care delivery system.

Families Will Pay Less

Currently, the average family of four covered under an employee health plan spends a total of $4,225 on health care annually – $2,713 on premiums and another $1,522 on medical services, drugs and supplies (Employer Health Benefits 2006 Annual Survey, Kaiser Family Foundation and Health Research and Educational Trust; U.S. Department of Labor, Bureau of Labor Statistics, Consumer Expenditure Survey.)  This figure does not include the additional 1.45% Medicare payroll tax levied on employees.  A study by Dean Baker of the Center for Economic Research and Policy concluded that under H.R. 676, a family of four making the median family income of $56,200 per year would pay about $2,700 for all health care costs.
 
Business Will Pay Less

In 2006, health insurers charged employers an average of $11,500 for a health plan for a family of four.  On average, the employer paid 74% of this premium, or $8,510 per year.  This figure does not include the additional 1.45% payroll tax levied on employers for Medicare.  Under H.R. 676, employers would pay a 4.75% payroll tax for all health care costs.  For an employee making the median family income of $56,200 per year, the employer would pay about $2,700.

Containing Annual Health Care Costs, While Covering All Americans

Savings from reduced administration, bulk purchasing, and coordination among providers will allow coverage for all Americans while reducing health care inflation in the long term.  Annual savings from enacting H.R. 676 are estimated at $387 billion (Baker).

Proposed Funding For The Improved Medicare For All Program

    •    Maintain current federal and state funding for existing health care programs
    •    Establish employer/employee payroll tax of 4.75% (includes present 1.45% Medicare tax)
    •    Establish a 5% health tax on the top 5% of income earners, 10% tax on top 1% of wage earners
    •    ¼ of 1% stock and bond transaction tax
    •    Close corporate tax loopholes
    •    Repeal the Bush tax cuts for the highest income earners
    •    Tax on unearned income: gambling, capital gains, or lotteries