- Mayor
Pete
Buttigieg
« Medicare
for
All Who Want It
Pete for America
For Immediate Release
September 19, 2019
Contact:
Chris Meagher
Pete Buttigieg Lays Out His “Medicare for All Who Want It” Plan
South Bend, IN - Today, Pete Buttigieg announced his ‘Medicare for All Who Want It’ plan to combat the rising cost of health care and give Americans the freedom to choose the best health care plan for themselves and their families. Buttigieg’s plan ensures universal access to coverage, makes health care more affordable for every American, and allows them real choice.
“We’re at this moment of crisis because of a failure of leadership,” said Buttigieg. “For years, Washington politicians have allowed the pharmaceutical industry, giant insurance companies, and powerful hospital systems to profit off of people when they are at their sickest and most vulnerable. My ‘Medicare for All Who Want It’ plan will create a health care system that puts power in the hands of each American.”
Pete’s Medicare for All Who Want It plan addresses the fundamental problem in the health care system today - cost. While it also achieves universal coverage, it is notably different from other Medicare for All plans in that it doesn’t force Americans off private plans they may want to keep, but offers them a meaningful public alternative. That’s why Pete’s plan to put American’s back in charge of their health care includes policies to:
- Ensure that all Americans have an affordable coverage option through a public coverage alternative.
- Guarantee universal coverage.
- End surprise billing.
- Expand premium subsidies for eligible Americans to make marketplace coverage dramatically more affordable for individuals and families.
- Provide much-needed relief for middle-income individuals and families by capping marketplace premium payments at 8.5 percent of income.
- Limit what health care providers, including hospitals, can charge for out-of-network care at twice what Medicare pays for the same service.
- Increase transparency of prices and the quality of health services and tackle high administrative costs to further bring down the costs of health care in America.
- Cap out-of-pocket costs for seniors on Medicare, with a lower cap for low-income seniors.
- Strengthen hospital community benefit requirements so that they truly serve the community.
- Make it easier to afford and find care for mental health and substance use disorder by enforcing parity.
- Empower the federal government to better monitor and challenge more health care mergers, which often raise the cost of care without improving outcomes.
Read his full plan HERE.
MEDICARE FOR ALL WHO WANT IT
Putting Every American in Charge of Their Health Care with Affordable Choice for AllThrough Pete’s Medicare for All Who Want It plan, everyone will be able to opt in to an affordable, comprehensive public alternative. This affordable public plan will incentivize private insurers to compete on price and bring down costs. If private insurers are not able to offer something dramatically better, this public plan will create a natural glide-path to Medicare for All. The choice of a public plan empowers people to make their own decisions regarding the type of health care that makes sense for them by leveling the playing field between patients and the health care system. It gives the American people a choice and trusts them to set the pace at which our country moves in a better direction on health care.
Pete’s coverage and affordability plan includes the following policy proposals:
BECAUSE HEALTH CARE IS A HUMAN RIGHT, GUARANTEE UNIVERSAL COVERAGE THROUGH MEDICARE FOR ALL WHO WANT IT.
The Medicare for All Who Want It public alternative will help America reach universal coverage by providing an affordable insurance option to the currently uninsured. The public alternative will provide the same essential health benefits as those currently available on the marketplaces and ensure that everyone has access to high-quality, comprehensive coverage.
The
plan will automatically enroll individuals in affordable coverage if
they are eligible for it, while those eligible for subsidized coverage
will have a simple enrollment option. A backstop fund will reimburse
health care providers for unpaid care to patients who are uninsured.
Individuals who fall through the cracks will be retroactively enrolled
in the public option.
END SURPRISE BILLING.
Most commonly, unexpected bills arise when a patient receives care at an in-network hospital and, unbeknownst to them, is treated by an out-of-network physician.4 This mismatch is a deliberate business strategy fueled by profit-driven firms in private equity.5 About one in five visits to the emergency room is likely to lead to a surprise bill.
Pete will require that bills related to in-network facilities be billed as in-network. His plan will also place limits on what out-of-network providers, including ambulances and air ambulance services, can charge.
EXPAND PREMIUM SUBSIDIES FOR LOW-INCOME PEOPLE TO MAKE MARKETPLACE COVERAGE DRAMATICALLY MORE AFFORDABLE FOR INDIVIDUALS AND FAMILIES.
Pete will make premium subsidies more generous for low-income people. Today, a family of three making $31,000 a year pays about $1,200 annually for “silver” coverage on the marketplace.6 Under Pete’s plan, they will pay a maximum of roughly $600 a year for higher quality (i.e., gold-level) coverage.
CAP MARKETPLACE PREMIUM PAYMENTS AT 8.5% OF INCOME FOR EVERYONE, WHICH WILL PRIMARILY HELP MIDDLE-INCOME INDIVIDUALS AND FAMILIES.
This
plan will also extend the subsidies to more middle-income people by
capping premium payments for everyone. That means that the 60-year-old
in Iowa making $50,000 and currently paying $12,000 annually in
premiums will now pay no more than $4,250 annually for gold coverage.
Pete will also lower out-of-pocket costs for consumers by increasing
cost-sharing assistance.
CAP OUT-OF-POCKET COSTS FOR SENIORS ON MEDICARE, WITH A LOWER CAP FOR LOW-INCOME SENIORS.
One in four Medicare beneficiaries—15 million people—spend over 20 percent of their income on premiums and medical care.7 Costs run much higher for many, including those with chronic disease and disability. The traditional Medicare program does not have a cap on out-of-pocket spending, putting seniors at risk of having medical or drug costs wipe out their savings. Pete believes that seniors in traditional Medicare deserve the same financial protection. He will improve affordability in Medicare by capping out-of-pocket costs, with lower caps for low-income seniors.
ENSURE THAT NON-PROFIT HOSPITALS TRULY SERVE THEIR COMMUNITY BY STRENGTHENING HOSPITAL COMMUNITY BENEFIT REQUIREMENTS.
Non-profit
hospitals do not pay federal taxes under the assumption that they
benefit their communities. Many benefit their communities in a number
of ways, such as by providing free care to uninsured patients and
offering medical training.8 However,
some
non-profit
hospitals
are
doing
little
to benefit their
community—sometimes even harming their own patients through aggressive
billing and predatory collection practices.9 Pete’s
plan
will
strengthen
community
benefit
requirements
to ensure that
hospitals are investing in the health of their patients and communities.
LIMIT WHAT HEALTH CARE PROVIDERS, INCLUDING HOSPITALS, CAN CHARGE FOR OUT-OF-NETWORK CARE AT TWICE WHAT MEDICARE PAYS FOR THE SAME SERVICE.
Health providers often charge private insurers exorbitant fees. As hospital prices for outpatient care increase at a rate four times faster than physician prices,10 hospital profits have risen to their highest levels in decades.11 As President, Pete will prohibit health care providers from pricing irresponsibly. This will also provide insurers with leverage to demand lower rates for in-network care.12 As noted in our rural health plan, for these providers in underserved areas, Pete’s administration will increase Medicare reimbursement rates and encourage states to increase Medicaid reimbursement rates.
MAKE IT EASIER TO AFFORD AND FIND CARE FOR MENTAL HEALTH AND SUBSTANCE USE DISORDER BY ENFORCING PARITY.
TACKLE HIGH ADMINISTRATIVE COSTS TO FURTHER BRING DOWN THE COSTS OF HEALTH CARE IN AMERICA.
Our
health care system is the most costly in the world in part because it
spends $496 billion annually on administrative costs—more than any
other system globally.13 To
lower
cost
and
improve
quality,
we
must make our health care system
more efficient. Pete’s plan will do this by harmonizing standards for
transactions and holding insurance companies accountable for adopting
them. It will simplify billing by creating a central clearinghouse for
claims,14 establish
an
All-Payer
Claims
Database
that
supports
health care quality
initiatives,15 and
require
integration
of
electronic
records.
EMPOWER THE FEDERAL GOVERNMENT TO BETTER MONITOR AND CHALLENGE MORE HEALTH CARE MERGERS, WHICH OFTEN RAISE THE COST OF CARE WITHOUT IMPROVING OUTCOMES.
Health insurers, hospitals, pharmaceutical companies, and health care provider groups are all growing larger, but bigger has not been better for patients. Greater consolidation among providers and insurers results in higher prices for patients without improving quality. To ensure robust competition in health care markets and protect patients, Pete will increase funding for federal antitrust authorities to empower them to review more mergers and equip them to bring enforcement cases against activity that harms competition and hurts health care workers.
By making care more affordable and available to everyone, we will finally put Americans back in charge of their own health care decisions. If you’re with us, text HEALTH to 25859.
FOOTNOTES
- Key Facts about the Uninsured Population.” Kaiser Family Foundation. December 7, 2018.Back to content
- Garfield, Rachel, Kendal Orgera, and Anthony Damico. “The Uninsured and the ACA: A Primer - Key Facts about Health Insurance and the Uninsured amidst Changes to the Affordable Care Act.” Kaiser Family Foundation. January 25, 2019.Back to content
- Collins, Sarah R., Herman K. Bhupal, and Michelle M. Doty. “Health Insurance Coverage Eight Years After the ACA.” Commonwealth Fund. February 7, 2019.Back to content
- Lewis, David. “The changing landscape of out-of-network reimbursement.” Milliman White Paper. September 2018.Back to content
- Kellett, Hunter, Alexander Spratt, and Mark Miller. “Surprise billing: choosing patients over profits.” Health Affairs. August 12, 2019.Back to content
- Scott, Dylan. “House Democrats new plan to strengthen Obamacare, explained.” Vox. March 26, 2019.Back to content
- Schoen, Cathy, Karen Davis, and Amber Willinik. “Medicare beneficiaries' high out-of-pocket costs: costs burden by income and health status.” The Commonwealth Fund. May 12, 2017.Back to content
- Hostetter, Martha and Sarah Klein. “In Focus: Hospitals Invest in Building Stronger, Healthier Communities.” Commonwealth Fund. September 23, 2016.Back to content
- Beil, Laura. “As patients struggle with bills, hospital sues thousands.” The New York Times. September 3, 2019. Hancock, Jay and Elizabeth Lucas. “‘UVA has ruined us’: Health system sues thousands of patients, seizing patients and putting liens on home.” The Washington Post. September 9, 2019.Back to content
- Rosenthal, Elizabeth. “That beloved hospital? It’s driving up health costs.” The New York Times. September 1, 2019.Back to content
- Gee, Emily. “The High Price of Hospital Care.” Center for American Progress. June 26, 2019.Back to content
- Chernew, Michael, et al. “The case for market-based price caps.” Health Affairs. September 3, 2019.Back to content
- Gee, Emily and Topher Spiro. “Excess administrative costs burden the U.S. health care system.” Center for American Progress. April 8, 2019.Back to content
- Emanuel, Ezekiel. “Democrats are having the wrong health care debate.” The New York Times. August 2, 2019.Back to content
- Calsyn, Maura. “Policy options to encourage all-payer claims databases.” Center for American Progress. April 20, 2018.
NH version
Pete Buttigieg Lays Out His “Medicare for All Who Want It” Plan
Manchester, N.H. — Today, Pete Buttigieg announced his ‘Medicare for All Who Want It’ plan to combat the rising cost of health care and give Americans the freedom to choose the best health care plan for themselves and their families. Buttigieg’s plan ensures universal access to coverage, makes health care more affordable for every American, and allows them real choice.
“We’re at this moment of crisis because of a failure of leadership,” said Buttigieg. “For years, Washington politicians have allowed the pharmaceutical industry, giant insurance companies, and powerful hospital systems to profit off of people when they are at their sickest and most vulnerable. My ‘Medicare for All Who Want It’ plan will create a health care system that puts power in the hands of each American.”
“As a retired nurse, I believe Pete Buttigieg’s health care plan will go a long way towards fixing our broken system and ensuring every American has affordable access to the services they need,” said State Representative Nancy Murphy. “Pete’s plan is impressive in its attention to detail, establishing mental health parity in Medicare and Medicaid and ending surprise billing by requiring all providers at in-network facilities to be in-network. In the United States, everyone should have access to healthcare -- yet even middle class families are being priced out. Pete’s comprehensive plan is exactly the kind of solutions-oriented thinking our entire country can rally around to deliver the most basic of rights -- the ability to lead a healthy life.”
Pete’s Medicare for All Who Want It plan addresses the fundamental problem in the health care system today - cost. While it also achieves universal coverage, it is notably different from other Medicare for All plans in that it doesn’t force Americans off private plans they may want to keep, but offers them a meaningful public alternative. Under Pete’s Medicare For All Who Want It plan, the 57 percent of Granite Staters who receive insurance through the employers would have the choice to keep their private plan.
Pete’s plan to put American’s back in charge of their health care includes policies to:
- Ensure that all Americans have an affordable coverage option through a public coverage alternative.
- Guarantee universal coverage.
- End surprise billing.
- Expand premium subsidies for eligible Americans to make marketplace coverage dramatically more affordable for individuals and families.
- Provide much-needed relief for middle-income individuals and families by capping marketplace premium payments at 8.5 percent of income.
- Limit what health care providers, including hospitals, can charge for out-of-network care at twice what Medicare pays for the same service.
- Increase transparency of prices and the quality of health services and tackle high administrative costs to further bring down the costs of health care in America.
- Cap out-of-pocket costs for seniors on Medicare, with a lower cap for low-income seniors.
- Strengthen hospital community benefit requirements so that they truly serve the community.
- Make it easier to afford and find care for mental health and substance use disorder by enforcing parity.
- Empower the federal government to better monitor and challenge more health care mergers, which often raise the cost of care without improving outcomes.
New Hampshire residents are already paying too much for health care. Since 2015, average monthly premiums in the state’s marketplace have increased by 60 percent. In addition to offering choice, Pete’s plan would make marketplace coverage more affordable for Granite Staters by restoring and expanding cost-sharing reduction payments to health plans and capping premium payments at 8.5% of income. And for private plans, Pete’s policy would lower overall costs by reducing high administrative costs and prohibiting providers from charging more than twice what Medicare pays for the same service.
Building on his rural health and mental health and addiction plans, in the coming weeks and months, Pete will release a series of additional plans to create a new era for health care in America including plans to reduce the cost of prescription drugs, protect and expand access to women’s health, drive health innovation, increase access to health equity, and more.
Read his full plan HERE.