‘Medicare for All’ gains backers, but bill still faces long odds in Legislature
Supporters of single-payer health care are rallying behind legislation that would transform Massachusetts’ health care system, a sign of lingering frustration with the status quo, even in a state that prides itself on being a leader in access to medical care.
The so-called Medicare for All legislation would raise taxes and eliminate private health insurance while putting the state in charge of all payments to doctors and hospitals.
The controversial measure is unlikely to become law anytime soon. But growing support for it shows the single-payer debate has shifted from the political fringes to the mainstream, in the state and across the country. Many of the Democrats running for president, including US Senator Elizabeth Warren, support a national health care system.
“This movement is growing across Massachusetts,” said state Senator Jamie Eldridge, an Acton Democrat and a lead sponsor of the bill.
The legislation has drawn 73 cosponsors — including the House and Senate chairwomen of the Committee on Health Care Financing. That’s up from 57 cosponsors when the bill was filed, but ultimately wasn’t approved, two years ago.
“People are growing frustrated with their health insurance companies,” said Eldridge, who testified before the health care committee Tuesday. “There’s a lot of talk about health care cost control, but I think there’s a recognition that costs are not going down.”
Massachusetts mandated insurance coverage for all residents in 2006; that became a model for the federal Affordable Care Act, which Congress passed four years later. An estimated 97 percent of Massachusetts residents now have health coverage.
But many Democrats say those laws don’t go far enough.
Eldridge’s plan would get rid of health insurance companies — as well as all premiums, copayments, and deductibles. His bill calls for a series of payroll and capital gains tax hikes, to generate an estimated $15 billion to $20 billion a year. For a middle-class family, that could be an additional $15,000 in taxes per year, he said.
The legislation would create a new agency, the Massachusetts Health Care Trust, to run the single-payer system. Federal officials would have to approve the plan before it could go into effect.
“Medicare for All is about health equity,” said Representative Lindsay N. Sabadosa, a Northampton Democrat and another lead sponsor of the legislation. “You should not receive better care because you have more money.”
It’s difficult to foresee a path forward for a bill that would so radically overhaul the state’s health care system. House and Senate leaders and Governor Charlie Baker are planning to work on health care legislation this year, but none of them have indicated they would consider a single-payer plan.
“Governor Baker does not support moving Massachusetts to a single-payer health care system,” said Brendan Moss, a spokesman for Baker (who ran a health insurance company before becoming governor).
“Governor Baker is focused on working with his colleagues in the Legislature to continue saving taxpayers hundreds of millions of dollars by strengthening controls on the MassHealth program and establishing tools to negotiate lower drug prices,” Moss added in a statement.
Baker’s opponent in last year’s election, Jay Gonzalez, made single-payer health care a signature issue of his campaign. He lost by a wide margin.
A spokeswoman for House Speaker Robert A. DeLeo said Tuesday that the House is reviewing the new Medicare for All legislation. Senate President Karen E. Spilka’s office said she was unavailable Tuesday.
Powerful health care lobbying groups also oppose the legislation.
“Mandating a one-size-fits-all, government-run health care system will eliminate health care options for patients,” Lora Pellegrini, president of the Massachusetts Association of Health Plans, said in a statement. “At a time when most Massachusetts residents have health insurance coverage, the single payer debate only distracts from the critical work we must do to control health care costs for employers and consumers across our state.”
Hospital leaders are worried that their revenues would shrink under a government-run health care system.
“The current ‘Medicare for All’ proposals — whether those under consideration in Washington or filed at the Massachusetts state level . . . put the viability of our crucial Medicare and Medicaid programs directly at risk,” Steve Walsh, president of the Massachusetts Health & Hospital Association, said in a statement.
State Representative Jennifer E. Benson, who cochairs the Legislature’s health care financing committee, said she has long supported single-payer health care. But she noted such a plan would face many hurdles: When and how would it be implemented? How would hospitals and drug companies be paid?
The committee’s other chairwoman, Senator Cindy F. Friedman, warned that a single-payer system would require the state to decide which medical services to cover and for which patients — decisions currently made by health insurers.
“Part of what we have to do in order to get to this single-payer system is to bring the public along with us,” Friedman said. “And the only way we can do that is be really transparent, be really clear about what this means, what it’s going to look like for them, what it’s going to cost, and what the trade-offs are.”