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Jayapal Introduces "Medicare for All" Bill

House Progressive Caucus co-chair Pramila Jayapal (D-Wash.) formally introduced her “Medicare for All” legislation last week. The 120-page Medicare for All Act of 2019 (H.R. 1384) would replace almost all private and employer-sponsored health insurance with a government-run health insurance system within two years. Every American would get an expanded array of health care for life, including long-term care. The bill does not detail how the overhaul would be financed. Jayapal has said that she plans to release a separate list of potential pay-fors. The legislation is an expansion on previously-introduced versions of Medicare for All. It currently has 107 Democratic cosponsors, and Jayapal hopes to garner the support of at least 40 more House Democrats.

Jayapal has received assurances from House leadership that the Budget and Rules committees will hold hearings on the bill. While he has supported similar measures in the past, House Budget Committee Chairman John Yarmuth (D-Ky.) has expressed reservations regarding Jayapal’s new legislation. He does not believe H.R. 1384 is comparable to the current Medicare system, given the elimination of private insurance and cost-sharing. He stated that his panel plans to hold a hearing on all measures that would expand the Medicare program, possibly in June. While Speaker of the House Nancy Pelosi (D-Calif.) supports hearings on the legislation, she has also expressed some skepticism about the proposal, specifically regarding the cost of the bill. Pelosi has made recent remarks in favor of a government-run public option, rather than a full-scale single-payer health care system.

More centrist House Democrats, who have not signed on to the Medicare for All bill, would prefer to focus on improving the current health care system, including passing incremental changes to expand coverage and exploring the formation of an option for government-run insurance. The moderate New Democrat Coalition, a caucus of 101 lawmakers, asked the leadership of the House Energy and Commerce, Ways and Means, and Education and Workforce committees to prioritize stabilization of the Affordable Care Act (ACA) and the individual health insurance marketplace. The coalition urged their colleagues to bring down costs for consumers through the creation of a dedicated reinsurance program, additional premium assistance, more options for individuals nearing Medicare eligibility age, and reform of bidding areas to encourage competition. The lawmakers also expressed support for legislation (H.R. 5155) that would create state innovation grants that allow states the flexibility to experiment with new initiatives such as auto-enrollment or regional exchanges.

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