Summary
The political and public discourse around single-payer and “Medicare for All” proposals has rapidly gained momentum in 2019. Whereas in 2016, Medicare for All was championed most prominently and singularly by unsuccessful Democratic primary challenger Bernie Sanders (I-VT), in 2020 we will see nearly every Democratic presidential contender endorse a variation on the theme and will most certainly see the debate carried forward in the general election. However, major questions remain regarding the outlook and viability of such proposals, even within the Democratic party.
In this issue brief, we seek to reveal the topography of the current Medicare for All landscape. First, we examine the political landscape, including dynamics within and between the two parties, and compare the key design elements of the leading legislative proposals to enact Medicare for All. Next, we review recent milestones, such as the first congressional hearing on Medicare for All proposals, a preliminary analysis of single payer scoring considerations from the Congressional Budget Office (CBO), and attempts to advance public option plans at the state level. Finally, we discuss the potential outlook for Medicare for All concepts after 2020 and beyond. In Appendix A, we provide a side-by-side comparison of 11 key bills, including Medicare for All and public option proposals.