Kamala Harris for the People
July 29, 2019

Kamala Harris Releases Her Plan for Medicare for All


Praised As ‘Innovative,’ ‘Smart,’ ‘Carefully Designed,’ ‘Serious’ By Health Care Experts Including Former HHS Secretary Kathleen Sebelius


Read The Full Plan


Senator Kamala Harris is releasing her plan for Medicare for All today, laying out how best to get to universal coverage in a system where cost is not a barrier for people to get health care. The plan expands the Medicare system to give everyone access to comprehensive health care. Medicare for All will cover all medically necessary services, including emergency room visits, doctor visits, vision, dental, hearing aids, mental health and substance use disorder treatment, and comprehensive reproductive health care services. It will also allow the Secretary of Health and Human Services to negotiate for lower prescription drug prices.

“Right now, the American health care system is a patchwork of plans, providers and costs that have left people frustrated, powerless and insurance companies in charge. And the bottom line is that health care just costs too much,” Harris writes in a new Medium post today. “We need comprehensive health insurance that covers every American.”

Here’s how her plan works:


  • First, all Americans will immediately have the ability to buy into Medicare. This is similar to the immediate, introductory buy-in provided in Senator Sanders’ Medicare for All bill.
  • Second, it establishes an expanded Medicare system, with a 10-year phase-in period. During this transition, newborns and the uninsured will automatically be enrolled into this public Medicare plan. The extended phase-in period gives all doctors time to get into the system and provides a commonsense path for employers, employees, the underinsured, and others on federally-designated programs, such as Medicaid or the Affordable Care Act exchanges, to transition. Expanding the transition window will also lower the overall cost of the program.
  • Third, the plan allows private insurers to offer Medicare plans as a part of this system that adhere to strict Medicare requirements on costs and benefits. This would function similar to how private Medicare plans work today, which cover about a third of Medicare seniors, and operate within the Medicare system.

“This plan builds on the progress we made in the Affordable Care Act and expands upon its promise of universal coverage through a sensible expansion of the popular Medicare system,” said Kathleen Sebelius, the former Secretary of Health and Human Services in the Obama administration, who helped architect the Affordable Care Act. “To get all Americans covered by health insurance, where cost is not a barrier, we need innovative ideas like this. Senator Harris’ plan is a smart way to get to Medicare for All where all individuals and employers can transition smoothly into a system that covers everyone.”

“This is exactly the right approach to reduce health care costs and ensure our country smoothly transitions to universal health care,” said Kavita Patel, a Brookings fellow and former Obama White House health care policy advisor. “Senator Harris’ plan builds on our successful Medicare system by expanding benefits and dramatically curbing the power of insurance companies, all while providing comprehensive care that is currently missing from many health plans; services like dental care, hearing aids and long term care.  Harris’ vision of Medicare for All is achievable, clear, and demonstrates a firm commitment to making access to health care a right for all Americans, regardless of income.”

“Senator Harris’s plan balances idealism and pragmatism,” said Andy Slavitt, who ran the Medicare, Medicaid and the ACA for the Obama administration. “It says in effect: we have a mandate to get everyone affordable health care and put people over profits— but we don’t need to tear down the things people have and they like in order to do it.”

“The Harris plan is a carefully designed transition to Medicare for All,” said health care expert Topher Spiro. “It guarantees universal coverage in the short term while allowing families to move over to the Medicare plan at their own pace.”

“Senator Harris is outlining clear, serious and thoughtful proposals to finance her approach to Medicare for All,” said tax and economic policy expert Michael Linden. Her plans to ensure that Wall Street and multinational corporations are paying their fair share of taxes are both good ideas, and would generate enough revenue to offset her proposal's higher income threshold after which premium payments begin—$100,000 rather than $29,000—which is intended to help the middle class.”

To pay for this plan, Harris has pointed to a number of good ideas -- from an income based premium paid by employers, to higher taxes on the top one percent and taxing capital gains at the same rate as ordinary income, among others. One idea put forward by Senator Sanders, for example, is increasing taxes for families making as little as $29,000 a year. She believes that hits the middle class too hard, so she would not raise taxes on families making under $100,000 to help pay for this plan. 

To pay for this specific commitment, she would impose a new Wall Street trade tax -- taxing stock trades at 0.2%, bond trades at 0.1%, and derivative transactions at 0.002% -- and end foreign tax shelters by taxing offshore corporate income at the same rate as domestic corporate income. Together, these proposals would raise well over $2 trillion over ten years, more than enough to make up the difference from raising the middle class income threshold.

“I look at this issue through a fairly simple prism: each night, millions of Americans wake up at 3 o’clock in the morning worried about some aspect of their health care,” Harris continued on Medium. “How am I going to afford a $5,000 deductible just for walking my child into the emergency room because their fever won’t go down? How will I pay that surprise medical bill because the ambulance that took me to the hospital was out-of-network? How am I going to continue to see my doctor when I get a new job and my new insurance plan doesn’t have them in their network?”

“This isn’t about pursuing an ideology,” Harris said. “This is about delivering for the American people. Health care is personal to people and we should make sure we get it right.”

Read her full plan on Medium here.

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https://kamalaharris.org/medicare-for-all/#M2rd7BfWrP6PcItc.99

KAMALA HARRIS' PLAN FOR MEDICARE FOR ALL

WHY DO WE NEED MEDICARE FOR ALL?
Health care costs too much. Insurance companies and drug companies have been jacking up prices for so long that Americans now pay on average twice what people in other countries pay. Even though we spend more, we fail to cover 27 million Americans. The problem is getting worse: 7 million Americans have lost their health insurance under Donald Trump and many more are at risk with the fate of the Affordable Care Act under review in the courts. 

Meanwhile, those with insurance are waking up in the middle of the night worrying about staggering out-of-pocket costs. How am I going to afford a $5,000 deductible just for walking my child into the emergency room? How will I pay that surprise medical bill because the ambulance that carried me to the hospital was out of network?

In America, health care should be a right, not a privilege. Families with pre-existing conditions should not fear that they will be denied care. It’s why we need Medicare for All. 

Imagine changing a job and not having to worry about your health care coverage. Imagine going to the pharmacy and not having to worry about an outrageous price increase on the prescription drug you need. Imagine walking through those sliding glass doors at the emergency room knowing that you have a Medicare card that will ensure you get the treatment you need without a bill you can’t pay.

WHO WILL BE COVERED UNDER MEDICARE FOR ALL AND WHAT BENEFITS WILL BE OFFERED?
Medicare for All will provide every individual in America with access to comprehensive health care. It will cover all medically necessary services, including emergency room visits, doctor visits, hearing aids, vision, dental, mental health and substance use disorder treatment, and comprehensive reproductive health care services. These benefits will be covered — no deductibles, and no copays for high-quality care. The plan will also have strong caps on out-of-pocket costs. It will also empower the Secretary of Health to negotiate for lower prescription drug prices. My plan will give more Americans more options to gain access to the health care they need.

Under my Medicare for All plan, we will also expand the program to include other benefits Americans desperately need that will save money in the long run–for instance, an expanded mental health program including telehealth and easier access to early diagnosis and treatment, and innovative patient navigator programs to help people identify the right doctor and understand how to navigate the health system. It will provide a serious auditing of prescription drug costs to ensure Americans aren’t paying more for their prescription drugs than other comparable countries; a comprehensive maternal & child health program to dramatically reduce deaths, particularly among women and infants of color; and meaningful rural health care reforms, such as increasing residency slots for rural areas with workforce shortages and expanding loan forgiveness for rural health care professionals, to promote high-quality access to people regardless of their zip code.

WILL I BE ABLE TO KEEP MY DOCTOR UNDER MEDICARE FOR ALL?
Yes. 91% of eligible doctors participate in the Medicare program today. Envision a program where you can walk into a doctor’s office knowing that they are in-network and you can walk out without worrying about your out-of-pocket costs or a surprise medical bill. My plan recognizes that doctors, nurses, and your entire health care team who provide high-quality care will have a voice in their workplace and be paid at appropriate rates under my plan.

HOW DOES THIS PLAN WORK AND HOW WILL WE TRANSITION TO MEDICARE FOR ALL?
Under my Medicare for All plan, we will immediately allow people to buy into a Medicare Transition Plan through an extended 10-year phase-in period.

We will automatically enroll newborns (with an opt-out provision for families with employer-sponsored insurance) and the uninsured into a Medicare Transition Plan, and provide a commonsense path for employers, employees, the underinsured, children, and others on federally-designated programs, such as Medicaid or the Affordable Care Act exchanges, to transition into the Medicare Transition Plan. The Medicare Transition Plan will provide enhanced benefits with limited cost-sharing requirements and financial assistance for those who qualify based on income. During the transition, seniors will be able to keep their Medicare with immediate coverage of additional benefits such as dental, vision, and hearing aids.

Second, after the 10-year transition period, we will have a new Medicare framework where most Americans will be in an expanded and improved public Medicare plan. In my Medicare for All system, similar to Medicare Advantage today, private insurance plans can contract through Medicare and compete with the public Medicare plan. However, these private Medicare plans will be subject to stricter consumer protection requirements than under current law, such as getting reimbursed by Medicare for less than the cost of the public Medicare plan to ensure taxpayers aren’t subsidizing insurance company profits. Americans can then choose whether to stay in the public Medicare plan or opt-into a private Medicare plan.

WHAT ABOUT EMPLOYER-BASED PLANS?
 During the transition period, employers can continue to provide private health coverage to employees. However, employers will also have the opportunity to provide health care for their employees through the Medicare Transition Plan, with a shared responsibility payment. Employees will also have the option on their own to buy into the Medicare Transition Plan during the transition period.

Following the transition period, under my Medicare for All system, employers will have the option to provide a private Medicare plan for their employees that will be certified by the Medicare program, similar to how employers can offer Medicare Advantage plans today. Employees could choose to be in that employer Medicare plan, a different private Medicare plan, or the public Medicare plan.

WHAT ABOUT ORGANIZED LABOR AND UNION WORKERS?
Under my Medicare for All plan, union workers will have the option to join Medicare and stop sacrificing wages for better health care. Unions could also continue working with employers to offer a private Medicare plan option or supplemental benefits in addition to the Medicare plan.

Workers should and will be guaranteed the opportunity to join together in a union or other worker organization and have a collective voice in discussions concerning the health care issues that affect them. They can and should be allowed to pay dues and be active in organizations without retaliation.

 DOES YOUR PLAN AFFECT THE VA HEALTH SYSTEM OR THE INDIAN HEALTH SERVICE?
No. Those programs will remain untouched, but my Administration will stay vigilant to ensure that Veterans and Native Americans receive high-quality health care.

HOW DOES YOUR PLAN AFFECT SENIORS?
Seniors will be able to keep their Medicare with immediate coverage of additional benefits such as dental, vision, and hearing aids, and the Secretary will have the authority to use market leverage to secure the best prices for these products and services. Medicare Advantage plans would continue uninterrupted during the transition. And employer-sponsored health insurance would continue to be an option until we meet these shared principles as all Americans gain access to better coverage over the next decade. My Medicare for All plan would also phase-in coverage of comprehensive long-term services and supports, with a focus on consumer-directed home and community-based services.

HOW DOES YOUR PLAN AFFECT CHILDREN?
Newborns will be automatically enrolled into the Medicare Transition Plan with an opt-out provision for parents who have employer-sponsored coverage. Children currently covered by the state Children’s Health Insurance Program (CHIP) and Medicaid will have a pathway to transition onto the Medicare Transition Plan and ultimately into my Medicare for All system. Comprehensive services including prevention, wellness, and services to assist children with developmental delays will be included. All currently available Medicaid supplemental benefits to children, such as EPSDT, will be provided under my Medicare for All plan.

HOW DOES YOUR PLAN AFFECT PEOPLE WITH DISABILITIES?
People with disabilities will also transition to the Medicare system and have access to comprehensive long-term services and supports, as well as necessary equipment and assistance devices. Under my Medicare for All plan, long-term services and supports will be consumer-directed and provided in home- and community-based settings, unless the individual chooses otherwise.

HOW DOES YOUR PLAN AFFECT AMERICANS LIVING IN RURAL AREAS?
By expanding high-quality health care coverage to the uninsured and underinsured, my plan will substantially increase patient access at rural hospitals and clinics. Rural Americans will have better access to care through telehealth services. We will work to redesign and prioritize delivery system reforms for rural areas to promote innovative solutions to deal with critical workforce shortages and a lack of reliable access to trauma, obstetrics, and other hospital services.

HOW DOES YOUR PLAN AFFECT MEDICAID?
Medicaid will transition to the Medicare for All system, which will ensure that all current Medicaid benefits for low-income individuals will be covered. States will be required to make maintenance of effort payments to the Medicare program equal to the amounts they currently spend on Medicaid and CHIP, which will grow with inflation.

DOES YOUR PLAN ELIMINATE ALL PRIVATE INSURANCE?
No. Under my Medicare for All system, the power of big insurance companies will be greatly diminished. After the transition period, private insurance will only exist in two ways:

1) At the end of the day, Americans want to be able to choose their doctor and the care they receive, not the insurance company that provides it. Under my plan, private insurers can compete with the new public Medicare plan, as long as the plans they offer adhere to strict requirements like those laid out below. This would function similarly to how Medicare Advantage operates within the Medicare system today. Today, 35% of seniors are enrolled in private Medicare plans that get paid directly by Medicare and, in fact, 25% of current private Medicare insurance plans are already at or below 95% of Medicare costs.

In my Medicare for All system, Medicare will continue to set the rules of the road for these plans, including price and quality, and private insurance companies will play by those rules, not the other way around. But unlike under the current program, these private Medicare plans will be held to stricter consumer protection standards than they are today, such as getting reimbursed less than what the public Medicare plan will cost to operate, to ensure that they are delivering meaningful value and unable to profit off of gaming consumers or the government.

2) People will be able to purchase supplemental insurance covering services not included under Medicare for All, such as medical insurance for traveling abroad and cosmetic surgery. Employers will still be able to offer their employees retiree supplemental coverage through a private insurance plan.

 HOW WILL WE PAY FOR MEDICARE FOR ALL?
Right now, the US spends $3.5 trillion a year on health care. If we do nothing over the next decade, that number will skyrocket to an estimated $6 trillion a year.

That’s why over 200 economists around the country have said we will dramatically save money over the long run if we expand the Medicare program to include everyone and limit profits for drug companies and insurance companies. We will also save money by accelerating delivery system reforms and value-based care that rewards meaningful outcomes instead of promoting performing unnecessary tests and procedures.

Senator Sanders, for example, has put forward a number of ways to help pay for his Medicare for All plan, including an income based premium paid by employers, higher taxes on the top 1%, taxing capital gains at the same rate as ordinary income, among others.

I think these are good options, especially making the top 1% and corporations pay their fair share through a more progressive income, payroll, and estate tax.

However, one of Senator Sanders’ options is to tax households making above $29,000 an additional 4% income-based premium. I believe this hits the middle class too hard. That’s why I propose that we exempt households making below $100,000, along with a higher income threshold for middle-class families living in high-cost areas.

To pay for this specific change, I would tax Wall Street stock trades at 0.2%, bond trades at 0.1%, and derivative transactions at 0.002%. Think of it like this: that’s a $2 fee on a $1,000 trade by investors and big banks. I would also end foreign tax shelters by taxing offshore corporate income at the same rate as domestic corporate income. Together, these proposals would raise well over $2 trillion over ten years, more than enough to make up the difference from raising the middle class income threshold.

In total, this plan will reduce our country’s health care costs and lower Americans’ out-of-pocket costs, all while extending health insurance coverage to every American.


Read more at https://kamalaharris.org/medicare-for-all/#M2rd7BfWrP6PcItc.99


July 29, 2019

Experts and Analysts Praise Kamala Harris’ Medicare for All Plan

“Clear, Serious And Thoughtful,” “Detailed,” “A Great Step Forward,” “A Pragmatic Path To Universal Coverage,” “Exactly The Right Approach”

This morning, Senator Kamala Harris released her Medicare for All plan to deliver universal coverage and ensure that cost is not a barrier for people to get health care.

The early reviews of Senator Kamala Harris’ plan are in. Here are some of the reactions from experts, analysts, and the coverage: 

  • Kathleen Sebelius, former Secretary of Health and Human Services in the Obama administration and architect of the Affordable Care Act: “This plan builds on the progress we made in the Affordable Care Act and expands upon its promise of universal coverage through a sensible expansion of the popular Medicare system. To get all Americans covered by health insurance, where cost is not a barrier, we need innovative ideas like this. Senator Harris’ plan is a smart way to get to Medicare for All where all individuals and employers can transition smoothly into a system that covers everyone.”

  • Dr. Kavita Patel, Brookings fellow and former Obama White House health care policy advisor: “This is exactly the right approach to reduce health care costs and ensure our country smoothly transitions to universal health care. Senator Harris’ plan builds on our successful Medicare
    system by expanding benefits and dramatically curbing the power of insurance companies, all while providing comprehensive care that is currently missing from many health plans; services like dental care, hearing aids and long term care.  Harris’ vision of Medicare for All is achievable, clear, and demonstrates a firm commitment to making access to health care a right for all Americans, regardless of income.”

  • Dr. Kavita Patel: "Sen. Harris is serious on healthcare. This is a pragmatic path to universal coverage. I always said the ACA was step one. There are critical pieces of the ACA that are informing Harris' team. ACA was our path to universal coverage."

  • Andy Slavitt, who ran the Medicare, Medicaid and the ACA for the Obama administration: “Senator Harris’s plan balances idealism and pragmatism. It says in effect: we have a mandate to get everyone affordable health care and put people over profits— but we don’t need to tear down the things people have and they like in order to do it.”

  • Andy Slavitt: “I think what she’s saying is if the private sector can add value, then power to them. She’s leaving room for innovation, but she’s also saying there ought to be a pretty high bar.”

  • Andy Slavitt: “BREAKING: Harris puts forward a credible plan to cover all Americans that is a mix of ideology & pragmatism. Democratic plans do have key distinctions from one another, but more important is the massive chasm from life & death under Trump.”

  • Michael Linden, tax and economic policy expert: “Senator Harris is outlining clear, serious and thoughtful proposals to finance her approach to Medicare for All. Her plans to ensure that Wall Street and multinational corporations are paying their fair share of taxes are both good ideas, and would generate enough revenue to offset her proposal's higher income threshold after which premium payments begin—$100,000 rather than $29,000—which is intended to help the middle class.”

  • Topher Spiro, health care expert: “The Harris plan is a carefully designed transition to Medicare for All. It guarantees universal coverage in the short term while allowing families to move over to the Medicare plan at their own pace.”

  • Topher Spiro: “The Harris plan is essentially "Medicare for all who want it" to build a smooth, natural pathway to Medicare for All...This plan guarantees universal coverage in the short term while allowing families to move over to the Medicare plan at their own pace.”

  • Topher Spiro: “Kamala Harris's plan for Medicare for All is based on the actual current Medicare program, but with enhanced benefits.”

  • Topher Spiro: “This plan is very ambitious, and at the same time thoughtful and pragmatic. It should ease concerns people have about disruption.”


  • Neera Tanden, CAP: “This is really great. @kamalaharris has an excellent transition to a Medicare for All that is based on the actual Medicare program.  Really well done.”

  • Bakari Sellers, CNN Contributor: “Today @KamalaHarris is being criticized by opponents for actually putting forth solutions and listening to voters/real ppl who are affected by policy decisions. Listening to voters is such a surreal concept to some…”

  • Dan Diamond, Politico: “KamalaCare is finally here. Sets up a 10-year path to universal coverage, with Americans choosing between a souped-up Medicare or a Medicare plan run by a private insurer. Obama health vets Sebelius, Slavitt among those praising plan.”

  • Jonathan Cohn, Huffington Post: “Kamala Harris has spent the campaign pledging to support "Medicare for All". Today she is telling Democratic voters what exactly she means by that”

  • Sarah Kliff, New York Times: “The new M4A plan from @KamalaHarris is something I'm surprised we haven't seen earlier in the election cycle: a middle ground between Sanders' single-payer and the rest of the field's public options.”

  • Abby Goodnough, New York Times: “Medicare Advantage for all? Kamala Harris threads the needle with new universal coverage plan, would let private insurers offer plans providing all Medicare-provided services while also giving everyone the option of public Medicare”

  • Kyle Griffin, MSNBC: “Kamala Harris has released a healthcare proposal that would move every American into a Medicare-for-All system within 10 years, while allowing private insurers to offer competing plans, as long as they meet the standards of the government plan.”

  • David Rothkopf: “This is a v. good, sensible plan...exactly where it needs to be, balanced and sound. Well done, @KamalaHarris.”

  • Matthew Yglesias, Vox: “Harris’ version of Medicare for All is more like “Medicare” the American insurance program for seniors...On substance, though, it doesn’t seem like private insurers would be playing any meaningful role in this framework so much as continuing to exist in order to address a particular talking point that happens to have become salient.”

  • Sean Sullivan, Washington Post: “Significant moment in the 2020 race today. After @KamalaHarris faced mounting qs about her stance on health-care, she released a detailed Medicare-for-all plan.”

  • Andrew Paul Joyce, MSNBC: “Kamala Harris’s health care plan is the closest thing we’ve seen to a literal “Medicare for All” program. What we’ve been calling Medicare for All up to this point is actually (as most any of its proponents would concede) a Canadian-style single payer system.”

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FOR IMMEDIATE RELEASE
July 29, 2019

STATEMENT BY KATE BEDINGFIELD, DEPUTY CAMPAIGN MANAGER, REGARDING SENATOR HARRIS' HEALTH CARE PLAN

Senator Kamala Harris just released a health care plan that both backtracks on her long-promised – but then-hedged – support of Bernie Sanders' Medicare for All legislation while at the same time committing to still unraveling the hard-won Affordable Care Act that the Trump Administration is trying to undo right now. 

Senator Harris was not only an original co-sponsor of Bernie Sanders' Medicare for All bill – she was the very first Democratic co-sponsor of it and stood with Sanders at the press conference announcing that legislation. 

After she launched her campaign for president, Senator Harris confirmed her support for the Sanders bill, but then, after being pressed about the ramifications of denying voters the choice of private health insurance plans, began a long and confusing pattern of equivocating about her stance on health care in America. That pattern has now taken yet another twist. 

This new, have-it-every-which-way approach pushes the extremely challenging implementation of the Medicare for All part of this plan ten years into the future, meaning it would not occur on the watch of even a two-term administration. The result? A Bernie Sanders-lite Medicare for All and a refusal to be straight with the American middle class, who would have a large tax increase forced on them with this plan.  

To their credit, the Sanders campaign has been honest that the only way to enact Medicare for All without substantially raising taxes on the middle class would require "unicorns" and "magic wands."

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Bernie 2020
July 29, 2019

NEWS: Bernie 2020 Campaign Manager Faiz Shakir Comments on Sen. Kamala Harris' Health Care Plan

“Call it anything you want, but you can't call this plan Medicare for All."

DETROIT – Bernie 2020 campaign manager Faiz Shakir released the following statement on Sen.Kamala Harris' health care plan announced today:
 
“Call it anything you want, but you can't call this plan Medicare for All. Folding to the interests of the health insurance industry is both bad policy and bad politics. This plan is centered around privatizing Medicare, enriching insurance executives and introducing more corporate greed and profiteering into the Medicare system. Further, we can’t wait 10 years to fix a dysfunctional health care system. Sen. Sanders has pledged not to accept money from private insurance and pharmaceutical companies and executives, and any candidate who is serious about fixing our health care system must do the same. The time is long overdue to guarantee healthcare to every man, woman and child as a right, not a privilege, under a true Medicare for All system.”
 
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