By Senator Bernie Sanders
As the coronavirus continues to spread, and the United States climbs closer to 1 million cases and nearly 60,000 deaths, we face an unprecedented economic and health care crisis that demands an unprecedented response. While we work toward an economic solution that keeps people on the payroll, Washington is also in the midst of a crucial argument over how to help cover the costs of testing, treatment and all other essential care for the millions of people who are now uninsured or soon will be as the country faces record levels of job loss. This pandemic makes even more clear that we are all only as safe as the least-insured in our country.
Last week, the White House said it would give an unspecified amount of federal aid directly to hospitals to cover the costs of treating uninsured Covid-19 patients, but details have not been released, and the proposal leaves out all non-Covid-19—but still crucial—medical care. The week before, a handful of Democrats proposed spending hundreds of billions of dollars on expanding subsidies for COBRA—the program that allows those who have lost their jobs to continue, on a temporary basis, paying out-of-pocket for the health insurance coverage they received from their previous employer.
But there’s another, better way to guarantee that everyone in America gets all the health care they need, without cost, for the duration of the pandemic: Empower Medicare to pay all of the health care costs for the uninsured, as well as all out-of-pocket expenses for those with existing public or private insurance, for as long as this pandemic continues. Our Health Care Emergency Guarantee Act is more comprehensive than Trump’s vague proposal and less expensive than the Democrats’ COBRA expansion.
Let’s be clear: Even before this crisis began, 87 million Americans were uninsured or underinsured—struggling to get to a doctor when they needed to. Now the situation is much worse.
There is no doubt that the health care crisis we are facing right now is an emergency. Already, an estimated 9.2 million workers have lost their employer-sponsored insurance, and as many as 35 million people might lose coverage by the end of the crisis. Meanwhile, the cost of hospital treatment for the coronavirus amounts to tens of thousands of dollars, and patients struggling with the disease are desperately worried that they cannot afford treatment or might go bankrupt if they get it. To make matters worse, some of the communities hit hardest by the coronavirus, such as the undocumented, largely do not have any health insurance coverage at all.
Yet, unbelievably, in the midst of this horrific pandemic, Republicans in Congress have only continued their cruel and single-minded focus on repealing the Affordable Care Act. Further, Republican governors, like Greg Abbott in Texas, continue to fight against Medicaid expansion, leaving many of the most vulnerable people in their states desperate and sick.
While almost all Democrats understand the severity of the crisis and the need to act, too many of them are proposing a totally inadequate response that would simply lock in place the dysfunction and waste of our current health care system.
Subsidizing COBRA, as they have suggested, would be both expensive and ineffective: Not only would health insurance corporations make massive profits off the plan—profits that come at the cost of the American taxpayer—but it would still leave tens of millions uninsured or underinsured. And during this pandemic, a lack of insurance means more Covid-19 transmissions and more deaths.
Expanding COBRA during the pandemic would do nothing to cover those who already lacked insurance. It also won’t help the many Americans who continue to receive employer-provided health care but are still prevented from going to the doctor by massive deductibles and co-pays. In fact, the average family with employer-provided insurance faces $4,700 in out-of-pocket costs every year. The deductible alone for the average low-income worker is $2,600 a year. Maintaining the status quo does nothing to address these extraordinary costs, made worse during the pandemic economy.
Further, COBRA subsidies will only cement the inequities of our current health insurance system. Right now, low-wage workers are, on average, enrolled in plans with low premiums but higher deductibles. On the other hand, higher-wage employees, often professionals, have platinum plans with much higher premiums and far superior coverage. Expanding COBRA, which subsidizes only premiums, would treat high-income workers who lose their jobs far better than low-wage workers who do, even though the latter have suffered the brunt of the economic damage wrought by the pandemic.
The Health Care Emergency Guarantee Act would treat all people equally. For the duration of this crisis, under the act, Medicare will cover all medically necessary health care, including prescription drugs, for the uninsured, whether those who have recently lost their jobs or those who have been long without insurance. It is simply irresponsible and dangerous to the public to allow millions of people in this country to go without health coverage as a pandemic rips through our communities.
Medicare, under our plan, would also temporarily cover the copays, deductibles and other out-of-pocket costs for all medically necessary health care for those who are already insured. Here is how this simple and efficient plan would work: When people go to the hospital or doctor, they provide their insurance information. If they have insurance, their provider will bill Medicare for the out-of-pocket costs; if the individual is uninsured, the provider will bill Medicare for the entire cost of care. The patient will not be forced to pay any bills for their treatment.
This proposal would prevent insurance companies from decreasing coverage and ban surprise billing so patients don’t get unexpected charges later. It would also prevent price gouging by pharmaceutical companies by making sure the government pays the same lower price for prescription drugs as the Veterans Health Administration.
Allowing Medicare to cover out-of-pocket health care expenses during the pandemic isn’t just the right thing to do, it’s actually less expensive for taxpayers because, unlike COBRA, the government would not be covering the cost of expensive monthly premiums to insurance corporations.
The numbers make this clear. If 35 million Americans lose their employer-provided coverage, as estimated by Health Management Associates, subsidizing premiums to health insurance corporations through COBRA would cost $157 billion over four months, or as much as $472 billion over a year. And even then, these figures don’t include the outrageously high deductibles that many people would still have to pay. Meanwhile, the conservative Committee for a Responsible Federal Budget estimates that allowing Medicare to cover out-of-pocket expenses for everyone would cost around $150 billion over four months, or only $400 billion over a year. In other words, the Health Care Emergency Guarantee Act provides comprehensive coverage to far more Americans while saving taxpayers money.
The American people deserve a health care response to the pandemic that’s simple, easy to understand and doesn’t require them to fill out complicated forms or deal with an already stressed bureaucracy in order to receive care. Under this proposal, everyone in the United States, regardless of insurance coverage or immigration status, would be able to walk into a doctor’s office to receive the care they need without worrying about the cost.
At a time when many American families are waiting hours in food lines and are often unable to afford groceries, whatever amount of money is left in their pocket must be saved for the basic needs of their families, not exorbitant health care bills. When so many of our people are struggling economically and are terrified by the possibility of becoming sick with the coronavirus, the government must take the burden of health care costs off the backs of working people. The Health Care Emergency Guarantee Act would do just that.