As the 2020 United States election approaches, Medicare for All once again becomes a hot topic. If enacted, Medicare for All would change Medicare as we know it, which will have a huge effect on the roughly 168 million Americans who are currently enrolled in Medicare. As a Medicare beneficiary, you may be wondering: how exactly will Medicare for All affect my coverage?

Let’s explore the basics of what Medicare for All would look like here in America, and how it might change Medicare for anyone who is currently enrolled.

According to Senator Bernie Sanders, Medicare for All would be a single-payer health insurance program that provides healthcare coverage to all Americans.

Single-payer healthcare systems, also called universal healthcare, are currently in place in various countries around the world. These healthcare systems can have differing elements, such as:

  • how the health insurance is paid for
  • how the healthcare is delivered
  • how the health facilities are owned and operated

For example, in Canada, health insurance is administered by the government, but healthcare services are performed by professionals in private practices. Alternately, in Great Britain, health insurance is administered publicly, and healthcare services are performed in publicly run health facilities.

The Medicare for All proposal calls for a healthcare system similar to Canada through an expansion of Medicare. This expansion would include all necessary healthcare services, with no up-front cost to beneficiaries. Like most other tax-financed, single-payer systems, the cost of all healthcare services would be paid for through taxes.

The current proposal for Medicare for All would consist of a Medicare expansion. Currently, Medicare only covers Americans aged 65 and older, as well as those with certain chronic health conditions. Medicare beneficiaries are currently covered for:

  • Medicare Part A, which covers inpatient and outpatient hospital services, home health care, nursing facility care, and hospice care
  • Medicare Part B, which covers preventative care, diagnostic services, and treatment services for medical conditions
  • Medicare Part D, which helps cover prescription drug costs

Under the current proposal, Medicare for All would expand Medicare to include all necessary health services, such as:

  • inpatient services
  • outpatient services
  • long-term care
  • dental care
  • vision care
  • hearing care
  • prescription drugs

Medicare for All, which would be run and funded by the government and available to every single American citizen, would eliminate many of the elements associated with our current Medicare system, such as:

  • private insurance plans
  • age requirements for enrollment
  • yearly deductibles
  • monthly premiums
  • copayments or coinsurance during visits
  • high prescription drug costs

Medicare for All would be an expansion and overhaul of original Medicare, meaning that Medicare as we currently know it, Medicare Part A, Part B, Part C, Part D, and Medigap, would no longer exist.

The single biggest change to the current state of Medicare would be the elimination of Medicare Part C, or Medicare Advantage. Medicare Advantage plans are Medicare plans that are sold by private insurance companies contracted with Medicare. Without private insurance under Medicare for All, Medicare Part C would no longer be an option.

In 2019, 34 percent, or nearly one third of all Medicare recipients, were enrolled in a Medicare Advantage plan. The elimination of this type of plan would impact a huge portion of beneficiaries, some of whom enjoy Medicare Advantage simply because it is a private option. There are also some additional benefits to Medicare Part C, including increased medical coverage and savings on medical costs.

However, according to Bernie Sanders, Medicare for All would have even more benefits than what is offered now. Health coverage under Medicare for All would include all the services under current Medicare Advantage plans, plus more. All of this would be offered with no premiums, deductibles, or up-front costs, and it would be available for all Americans, regardless of age, income, or health status.

Not everyone believes in the viability and success of a single-payer healthcare system like Medicare for All. Joe Biden’s alternative to Medicare for All includes an expansion of the Affordable Care Act (ACA) that was enacted under President Obama in 2010. These changes would not impact Medicare beneficiaries in the same way that Medicare for All would.

The Patient Protection and Affordable Care Act or simply the Affordable Care Act (ACA), often referred to as Obamacare, was designed to create affordable healthcare options for more Americans.

As an alternative to Medicare for All, the changes according to Joe Biden, to the ACA would include:

  • more health insurance choices for all Americans
  • lower premiums and extended coverage
  • expanded coverage to include those with lower incomes
  • increased affordable options for enrollees
  • changes in billing practices and medical costs
  • reduced drug costs and improved generic options
  • expanded reproductive and mental health services

According to a recent review of the current literature, there are also two additional federal and 20 state proposals for a single-payer healthcare system here in the United States.

In addition to the Medicare for All Act, the other federal proposals for single-payer systems have included the American Health Security Act and the National Health Insurance Act. Like Medicare for All, these major proposals both push for a single-payer system in the United States. However, it’s Bernie Sanders’ push for the Medicare for All Act that has brought his proposal to the forefront of current public debates.

As it stands, the Medicare for All act has received strong support and opposition from all sides.

Proponents for the Medicare for All Act believe healthcare coverage for all individuals is a human right. They point out that every major country in the world can guarantee healthcare to all while showing better health outcomes and keeping the cost substantially less per capita than we do in the U.S. Stating that the current healthcare system in America is outdated compared to the coverage that is offered in other major countries around the world, they believe we can do better.

Proponents against the Medicare for All Act believe that universal coverage is far too costly and that even an increase in taxes would not fully cover the proposed costs. They also suggest that the quality of care beneficiaries currently receive would be greatly diminished under a universal, single-payer system, especially for individuals with certain conditions.

The current COVID-19 pandemic has also sparked a passionate debate as to how a single-payer healthcare system could impact worldwide disease outbreaks once they reach America.

Many people have made comparisons to how other countries have been able to tackle the pandemic with single-payer healthcare systems. However, it is impossible to know exactly how Medicare for All would impact a scenario such as pandemic socially, financially, or otherwise.

  • Ultimately, Medicare for All would have the biggest impact on Medicare beneficiaries by removing many of the Medicare options they are currently familiar with.
  • Medicare would no longer be available only to seniors and would expand to include coverage for all Americans.
  • Private Medicare options would no longer exist; however, all Medicare beneficiaries would be covered for their current services, plus more, with Medicare for All.

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