Medicare for All has been a highly discussed topic over the past year, but there’s another option that not as many people are talking about: Public Option. Both Medicare for All and Public Option are intended to offer affordable healthcare coverage for Americans. There are similarities between the two proposals, as well as some key differences to note.
In this article, we’ll discuss Medicare for All vs. Public Option, and how they may affect Medicare, and how they compare in providing health insurance for Americans.
Medicare for All is a government-funded national health insurance program that would provide comprehensive medical coverage to all Americans. The proposal for Medicare for All is based on an expansion of Medicare, the current health insurance program that covers individuals 65 years of age and older, and those with certain disabilities.
Medicare currently consists of:
- Medicare Part A. Part A covers services related to hospital care, home health care, skilled nursing facility care, and hospice care.
- Medicare Part B. Part B covers services related to preventative care, diagnostic testing, and treatment of health conditions.
- Medicare Part C. Part C covers both Medicare Parts A and B, and offers additional coverage, such as prescription drugs, dental, vision, and hearing.
- Medicare Part D. Part D helps cover the cost of your prescription drugs, and certain vaccines not covered under Part B.
- Medigap. Medigap helps cover the costs of your Medicare premiums, copayments, coinsurance, and other costs.
The expansion of Medicare to Medicare for All would include the essential parts listed above: Medicare parts A and B and prescription drug coverage. It would also be expanded to offer additional coverage that is not currently included in Medicare, such as:
- reproductive care
- maternity care
- newborn care
- pediatric care
- long-term care
With Medicare for All, the way we pay for healthcare would be different than the current system. There would be no up-front cost or cost-sharing at the time you need medical services. Instead, the entire system would be tax-financed, or paid for through taxes.
When eliminating cost-sharing, the single-payer system would eliminate private insurance plans such as Medicare parts C and D and Medigap. However, the out-of-pocket costs associated with those types of plans would also be gone, including:
Medicare for All would also aim to eliminate high prescription drug costs and expand currently available drug options.
The Public Option would offer essential health benefits, which include:
- inpatient and outpatient hospital care
- mental health and substance abuse care
- newborn and pediatric care
- prenatal and maternity care
- prescription drugs
- preventative, diagnostic, and treatment care
- rehabilitation care
With a Public Option, you can choose to forego private insurance in favor of the government-funded or state-funded option. However, you would not be required to enroll in the Public Option if you preferred to stick with a private plan. The Public Option could be tax-financed, like Medicare for All, or paid for by participants with a traditional pricing structure.
While Medicare for All would consist of an overhaul of the current Medicare structure, the Public Option might affect Medicare differently. For example, Public Option changes to Medicare could include:
- lowering the eligibility age for Medicare enrollment (Medicare at 50)
- expanding the eligibility requirements to include low-income individuals
- changing the Medicare offerings on the health insurance marketplace
- offering Medicare as a fallback option if other plans are too expensive
The goal for Public Option healthcare is to create a more affordable health insurance option for individuals who cannot afford to purchase private insurance. It would also offer coverage to people who do not usually qualify for private plans, such as individuals with pre-existing health conditions.
So, how does Medicare for All compare to a Public Option? Let’s discuss some of the similarities and differences between the two options.
The goal of both Medicare for All and Public Option are to provide individuals with a low-cost, affordable option for health insurance. Both types of health insurance systems would be non-profit, which would aim to lower beneficiary, administrative, and prescription drug costs.
Each option would include individuals who may otherwise not be able to receive health insurance through private entities. Individuals with low income and those with pre-existing health conditions could be covered under both insurance options.
Under Medicare for All, only one health insurance option would be available. Everyone would be eligible and covered for essential health benefits. There would be no private insurance options and no marketplace competition. The goal would be to lower healthcare costs for individuals, who would no longer pay up-front fees for services. This option would be entirely tax-funded and government-run.
A Public Option would be an opt-in health insurance option for individuals, rather than a mandatory option for all Americans. Private health insurance options would still exist, but the Public Option would compete to bring overall health insurance costs down. The Public Option could be funded through taxes, like a single-payer tax-funded system, or through the cost of individual enrollment.
Given the similarities and differences between the two health insurance proposals, you may be wondering how each of these options will affect your own medical and financial situation. Below is a comparison chart of the primary coverage and costs for Medicare for All and Public Option.
Medicare for All coverage vs to Public Option coverage
|Opt-in||Low-income||Pre-existing||Funding method||Coverage included||Cost savings||Competing plans|
|Medicare for All||no||yes||yes||tax-funded||essential health benefits||overall cost reduction||none|
|Public Option||yes||yes||yes||tax-funded or individual-funded||essential health benefits||possible cost reduction||private plans|
The biggest difference between the two proposals is the option for enrollment: Medicare for All is a mandatory single-payer healthcare system that covers all Americans, while Public Option offers an optional healthcare plan to all Americans who qualify and want to opt-in.
Discussions about health insurance are at the forefront of the current political and social climate. No matter which side of the political spectrum Americans fall on, many individuals still want more affordable health insurance options. However, that doesn’t necessarily mean that everyone favors a single-payer healthcare system like Medicare for All. There also hasn’t been much talk about a Public Option, which could provide an
It’s hard to say exactly how proposals like Medicare for All and Public Option fit into the future of American healthcare, but we will continue to see how these issues evolve as we approach the 2020 presidential election and beyond.
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