Revamped “Medicare for All” Bill Would Eliminate Employer-Based Health Insurance

April 12, 2019

Flanked by other presidential candidates, Sen. Bernie Sanders (I-VT) reintroduced his single-payer health care bill that would prohibit all private health insurance—including employer-based insurance—that duplicates the new government coverage.

The bill largely mirrors Sen. Sanders’ 2017 Medicare for All bill, with the biggest difference being the addition of a long-term care benefit that would cover the care for patients at home or in community settings.

A benefit package far more comprehensive than other single-payer countries:  The plan would cover all medically-necessary services in 10 benefit categories and would eliminate nearly all out-of-pocket costs for patients, including premiums, deductibles, and co-pays. It would also cover dental and vision care, whereas single-payer systems in Canada, the Netherlands, and Australia do not cover these types of services.

Where does funding come from?  While the bill does not explain how it would be funded, Sen. Sanders’ office released a list of possible options that include:

  • Creating a 4% income-based premium paid by employees, exempting the first $29,000 in income for a family of four;

  • Imposing a 7.5% income-based premium paid by employers, exempting the first $2 million in payroll; and

  • Making the federal income tax more progressive, including a marginal tax rate of up to 70% on those making above $10 million.

Outlook:  While the bill currently has no chance of passing the Senate, it shows that single-payer health care is likely to be a key issue for Democrats in the 2020 presidential election. Joining Sen. Sanders were several of the other Democratic senators running for president, including Sens. Cory Booker (D-NJ), Kamala Harris (D-CA), Kirsten Gillibrand (D-NY), and Elizabeth Warren (D-MA).

To learn more about health care reform proposals, read the American Health Policy Institute’s series, “Understanding Health Care Reform”:

Read Part I:  "Employers and the U.S. Health Care System"

Read Part II:  "The Health Care Reform Spectrum"

Read Part III:  "Spotlight: Replace the ACA"

Read Part IV:  "Spotlight: Medicare for All Act"

Read Part V:  "Spotlight: Medicare Extra for All Proposal"

Read Part VI:  "Implications for Employers"