Medicare-for-all to get a hearing before the House Budget Committee today

Senator Elizabeth Warren (D-MA) speaks during an event to introduce the "Medicare for All Act of 2017" on Capitol Hill in Washington, U.S., September 13, 2017. REUTERS/Yuri Gripas - RC141820F110

The Washington Post reports, Single-payer health care gets a second Captiol Hill hearing today.

Medicare-for-all is poised for another big day on Capitol Hill, as the House Budget Committee convenes this morning to examine the intricacies and challenges of any U.S. transition to a unified health-care system run by the government.

As in a similar House Rules Committee hearing last month, there will be plenty of back-and-forth between Democrats and Republicans over whether a single-payer system would be a good idea at all. The GOP members, who have been chomping at the bit to put Democrats on the spot over Medicare-for-all, will charge that such a system would hurt access to care, worsen the care itself and cost the government way too much money to administer.

But today’s hearing is also the perfect opportunity for Democrats to dive deep into the nitty-gritty logistics of setting up such a system, given that they’ll be hearing from three Congressional Budget Office analysts who recently completed a report on the highly complicated subject — one that raised more questions than it gave answers.

The Democrat running the hearing, House Budget Committee Chairman John Yarmuth (D-Ky.), isn’t exactly a Medicare-for-all crusader. He has voiced some skepticism of the sweeping Medicare-for-all bill from Rep. Pramila Jayapal (D-Wash.) and last week told my Washington Post colleague Dave Weigel there’s no “sense of urgency” to move on the legislation “because it’s not going anywhere.”

So Yarmuth is likely to raise some serious questions around single-payer systems — such as how to pay for the whole thing and what benefits it should cover — while stressing that Democrats share an overarching goal of closing the gap of uninsured people and making coverage more affordable for everyone else, even if they don’t agree on Medicare-for-all.

“Too many American families still must make the impossible choice between going to the doctor or putting food on their table; filling their gas tank or refilling a prescription,” Yarmuth plans to say in his opening statement, shared in advance with The Health 202.

“We cannot accept this tragic reality as the status quo. Progress must produce more progress, and we must begin to pursue the next wave of health care reforms.”

As we’ve written, the CBO report on single-payer systems laid out many pros and cons of moving everyone to a government-run health plan, but it didn’t offer many specifics. It reads more like a list of the questions Congress would need to answer in passing a Medicare-for-all system. But there is a relatively extensive analysis of Medicare-for-all, completed by the University of Massachusetts at Amherst at the end of last year. This 200-page report focuses on the very first Medicare-for-all bill introduced in 2017 by Sen. Bernie Sanders (I-Vt.) and is much more extensive than oft-cited analysis from the Urban Institute and the Mercatus Center (we’ve written about those reports here).

The University of Massachusetts analysts reached mostly positive conclusions about the effects of Medicare-for-all once implemented — although it’s important to remember they had to make lots of assumptions that might not necessarily bear out in real life. Here’s a brief synopsis of their conclusions:

1. It would lower costs for people at lower and middle incomes and increase costs for those at higher incomes.

Middle-income families would see their net costs for health care fall by 2.6 percent to 14 percent of their income. Net costs would rise an average of 3.7 percent of income for the top 20 percent of income-earners and 4.7 percent of income for the top 5 percent of earners, the researchers found.

2. Businesses could also save on health-care costs. Sanders has proposed increasing payroll taxes or enacting a gross receipts tax to help pay for the plan, but the higher taxes would be offset by savings from employers not having to pay premiums. The researchers estimate their health-care costs could fall between 8 and 13 percent.

3. Americans would consume more health-care services. People would presumably use more services if they aren’t charged a co-pay, as Sanders has suggested. The researchers estimate that would increase demand by 12 percent.

4. But costs overall would fall by 19 percent relative to the current system because a government plan could achieve savings that private insurers can’t. The researchers estimate a Sanders-style system would reduce administrative costs by 9 percent, pharmaceutical prices by 5.9 percent, and payments to hospitals, physicians and clinics by 2.8 percent.

Overall, the researchers emerged with a favorable analysis of Medicare-for-all. “The most fundamental goals of Medicare for All are to significantly improve health care outcomes for U.S. residents while also establishing effective cost controls throughout the health care system,” they wrote. “We conclude that these two purposes are both achievable.”

Democrats are continuing to pursue their legislative agenda “for the people” in the House while “The Enemy of The People,” Senate Majority Leader Mitch McConnell has resorted to his “total obstruction” policy and is spending the Senate’s time packing the federal courts with unvetted and unqualified conservative nominees, whose only qualification is that they meet the litmus test of the Federalist Society for overturning Roe v. Wade. Washington Post: A conservative activist’s behind-the-scenes campaign to remake the nation’s courts; earlier, from The Daily Beast: The Secrets of Leonard Leo, the Man Behind Trump’s Supreme Court Pick. These are truly evil people.