Critique of HR 1384 Roll out by ISPC Working Group on Long Term Care final August 2019

HR 1384 Medicare for All Act of 2019

https://www.congress.gov/bill/116th-congress/house-bill/1384/text

[Comments by the Working Group are in brackets, red, and underlined, like this sentence. The regular text is from the bill.]

SEC. 106. EFFECTIVE DATE OF BENEFITS.

(a) In General.—Except as provided in subsection (b), benefits shall first be available under this Act for items and services furnished 2 years after the date of the enactment of this Act.

(b) Coverage For Certain Individuals.—

(1) IN GENERAL.—For any eligible individual who—

(A) has not yet attained the age of 19 as of the date that is 1 year after the date of the enactment of this Act; or

(B) has attained the age of 55 as of the date that is 1 year after the date of the enactment of this Act,

benefits shall first be available under this Act for items and services furnished as of such date.

(2) OPTION TO CONTINUE IN OTHER COVERAGE DURING TRANSITION PERIOD.—Any person who is eligible to receive benefits as described in paragraph (1) may opt to maintain any coverage described in section 901, private health insurance coverage, or coverage offered pursuant to subtitle A of title X (including the amendments made by such subtitle) until the date described in subsection (a).

[Making some people wait a year longer than others to get into Medicare for all is not fair.

Enrollment in national improved Medicare for all should happen as quickly as possible and should apply to everyone at the same time.

Most people of childbearing years will be among those who have to wait an extra year for coverage. The US has a dismal record for maternal and infant morbidity and mortality, especially for black people. Single-payer is necessary (but not sufficient) for eliminating this problem and we must address it as quickly as possible.

Staggering enrollment undermines the inauguration of Medicare for all.

Some people will be uninsured. Some people will die due to underinsurance or lack of insurance during the long roll-out period.

Some people who think they like their insurance will find out that it doesn’t cover them when they need it. Some people will buy cheap catastrophic plans that provide almost no coverage.

Even after single-payer passes, insurance companies will spend a lot of money to try to sabotage and reverse it.

Insurance companies may temporarily improve their benefits in order to convince people that private insurance is better.

Single-payer only works properly if we get rid of insurance companies. Keeping them involved means we will still have bureaucracy and inefficiency.

The staggered enrollment by your age on a certain date is very confusing.

We have to get insurance companies out of health care!]