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Liberal Health Plan Expands Coverage   02/22 06:22

   A major liberal policy group is raising the ante on the health care debate 
with a new plan that builds on Medicare to guarantee coverage for all.

   WASHINGTON (AP) -- A major liberal policy group is raising the ante on the 
health care debate with a new plan that builds on Medicare to guarantee 
coverage for all.

   Called "Medicare Extra for All," the proposal to be released Thursday by the 
Center for American Progress gives politically energized Democrats more options 
to achieve a long-sought goal.

   In a nod to political pragmatism, the plan would preserve a role for 
employer coverage and for the health insurance industry. Employers and 
individuals would have a choice of joining Medicare Extra, but it would not be 

   That differs from the more traditional "single-payer" approach advocated by 
Vermont independent Sen. Bernie Sanders, in which the government would hold the 
reins of the health care system.

   Even though the plan has no chance of passing in a Republican-controlled 
Congress, center president Neera Tanden said, "We think it's time to go bolder."

   "There is consensus on the progressive side that universal coverage should 
be the goal and health care is a right," she added.

   Picking up on the leftward shift among Democrats, Republicans are already 
working up rebuttals. President Donald Trump tweeted earlier this month that 
"Dems want to greatly raise taxes for really bad and non-personal medical care. 
No thanks!"

   The Center for American Progress is a think tank that was closely aligned 
with President Barack Obama and 2016 Democratic presidential nominee Hillary 
Clinton. A 2005 proposal from the center foreshadowed Obama's Affordable Care 

   Medicare Extra would use Medicare's thrifty payment system as a framework to 
pool working-age people and their families, low-income people now covered by 
Medicaid, and seniors. A major missing piece: There's no cost estimate for the 
plan, although its authors say that's in the works.

   The proposal comes at a time when polls show intense interest among 
Democrats and some independents in a government-run system that would guarantee 
coverage and benefits while reducing the complexity and out-of-pocket costs 
associated with private insurance. The future of health care is expected to be 
a defining issue in the 2020 Democratic presidential primaries, and political 
messages will be tested and honed in this fall's midterm elections.

   A nonpartisan expert who independently reviewed the Medicare Extra plan said 
it could provide Democrats with a middle way to achieve their longstanding goal 
of coverage for all.

   "It's an attempt to capture the enthusiasm for a single-payer system among 
the Democratic base, but trying to create a more politically and fiscally 
realistic roadmap," said Larry Levitt of the nonpartisan Kaiser Family 

   To be sure, taxes would rise and the federal government would take on a 
larger role.

   "It is in some ways 'repeal and replace,' but from the left rather than the 
right," Levitt added.

   Medicare Extra envisions a complex transition that would take the better 
part of a decade. Among its major elements:

   ---All U.S. citizens and lawful residents would be automatically eligible 
for coverage.

   ---Preventive care, treatment for chronic disease, and generic prescription 
drugs would be free. Dental, vision and hearing services would be included.

   ---Low-income people would pay no premiums or copays. Premiums and 
cost-sharing would be determined according to income for everyone else.

   ---Employers would have the option of maintaining their own plans or joining 
Medicare Extra. Workers could pick the government plan over their employer's. 
The proposal would preserve the tax-free status of employer-provided health 
care, subject to a limit.

   ---Seniors with private Medicare Advantage insurance plans through Medicare 
would be able to keep similar coverage, although the program would be 
redesigned and called "Medicare Choice." Seniors would gain coverage for 
vision, dental and hearing services not now provided by Medicare. Long-term 
care services would be covered.

   ---Government would negotiate prices for prescription drugs, medical devices 
and medical equipment.

   Although costs and financing are not spelled out in the proposal, its 
authors acknowledge significant tax increases would be required. Options 
include rolling back some of the recently enacted GOP tax cuts for corporations 
and upper-income people, raising Medicare taxes on upper-income earners, and 
higher taxes on tobacco and sugary soft drinks.


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