As our country works to expand health coverage and improve access to care, “Medicare for All” is getting a lot of attention. There are many different flavors so it’s worth diving a little deeper into what “Medicare for All” really means. A new report released on Tuesday shows exactly what one proposed “Medicare for All” bill would do – and how it will impact hospitals, health systems and patients’ access to care.

The AHA and the Federation of American Hospitals asked KNG Health Consulting to analyze the Medicare-X Choice Act, which would create a government-run, Medicare-like health plan on the individual exchange. And what they found is that this plan would create the largest-ever cut to hospital services – nearly $800 billion over 10 years – and would have a significant impact on patients’ access to care in communities all across the country.

Clearly, this proposal would hurt hospitals’ abilities to keep pace with new, life-saving advances in medicine … invest in new payment and delivery models … attract and retain talent necessary to provide care … manage skyrocketing drug prices … and innovate and transform to meet patients’ needs in the future. 

As David Brooks wrote in The New York Times on “Medicare for All”: “There’s no plausible route from here to there … Americans are more decentralized, diverse and individualistic than people in the nations with single-payer systems … [and] tend to dislike higher taxes.” In other words: We’d all have to get used to higher taxes, longer wait times and less control over our health care. 

Here’s the clincher: Medicare and Medicaid are already subject to politicization and micromanagement by Congress. If more people get coverage through the government, then more people will have their health care subjected to political fights and uncertainty that may not have anything to do with health care. Example: reducing provider payments to offset funding for other priorities. 

This past Monday, we saw another reason to be wary of a “Medicare for All” approach: President Trump’s 2020 budget request calls for cutting hundreds of billions of dollars from Medicare. When the federal government is such an unreliable partner and cutting an already underfunded program, we cannot support expanding the scope of that program.

Here’s the takeaway: There’s a better way to expand coverage. Under Medicare-X Choice, there would be a modest drop in the number of uninsured Americans … whereas 9.1 million Americans would gain insurance coverage if we fully implemented the existing public-private coverage framework. This includes expanding Medicaid in all states, restoring cost-sharing reduction payments, and fully funding open enrollment efforts … just to name a few. This would be a better alternative: more people covered with less harm to the health care system.

There’s no doubt that our country needs better coverage and better access. “Medicare for All” sounds like a good idea … but strengthening the public-private coverage framework we have is the best way forward for expanding coverage, increasing access to care, and advancing health in America. 


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