More Than Medicare-for-All: Proposals to Achieve Universal Health Coverage

Since the passage of the ACA, more than 20 million Americans have gained health insurance. But the fight for affordable and accessible universal coverage continues.

Here are just some of the proposals that have been introduced in Congress:

• The Medicare for All Act of 2019 (H.R. 1384/S.1129) would establish a national health insurance program administered by HHS.

• The State Public Option Act (H.R. 1277/S.489) would allow states to offer residents of all incomes the option to buy into Medicaid. This option would compete with private plans on the ACA Marketplace.

• The Medicare Buy-In & Health Care Stabilization Act of 2019 (H.R. 1346) would allow individuals aged 50 to 64 to buy into Medicare and provide some marketplace stabilization.

• The Medicare-X Choice Act of 2019 (H.R. 2000/S.981) would build on the Medicare framework to establish a low cost public option for families, individuals, and small businesses. It would initially be available in areas with a shortage of insurers or high costs due to less competition.

• The Medicare for America Act of 2019 (H.R. 2452) would create a national insurance program open to all U.S. residents (replacing Medicare, Medicaid, and individual market plans) but leaves the option of employer-sponsored coverage.

• The Choose Medicare Act (H.R. 2463/S.1261) would give everyone not enrolled in Medicaid or Medicare the option to enroll in Medicare and give employers the option to purchase Medicare for their employees.

• The Expanding Health Care Options for Early Retirees Act (H.R. 4527/S.2552) would allow first responders between 50-64 who are no longer in service due to retirement or disability to buy into Medicare.

• The Incentivizing Medicaid Expansion Act of 2019 (H.R. 584) would enhance the federal financial match for states that choose to expand Medicaid beyond the dates set forth in the ACA.

• The Consumer Health Options and Insurance Competition Enhancement Act – CHOICE Act – (H.R. 2085/S.1033) would establish a public option for individuals and small business on the marketplaces.

The House Energy & Commerce Committee recently held a hearing on all of these proposals. The witnesses included sponsors of the legislation (Members of Congress), health policy experts, and health care leaders. You can watch the hearing here.

Image from Health Affairs.