House Speaker Nancy Pelosi (D-Calif.) has made clear she would prefer to improve upon the Affordable Care Act, the sprawling 2010 health-care law that has extended coverage to roughly 20 million people.
The report from the nonpartisan Congressional Budget Office was a high-level look at the pros and cons of changing the current mix of public and private health care financing to a system paid for entirely by the government. Bernie Sanders (I-Vt.) introduces Medicare-for-all legislation.
Jayapal's bill, H.R. 1384, is far more generous than that plan or the legislation proposed by Sanders.
Instead, the discussion was fairly wonky in a way the presidential campaign hasn't yet become.
"An expansion of insurance coverage under a single-payer system would increase the demand for care and put pressure on the available supply of care", the report said. "On the day we are born and on the day we die, and on so many days in between, all of us need medical care". On the plus side, it says, such a plan would produce universal coverage and probably a more efficient health system. It would cover prescription drug costs and allow the government to negotiate drug prices directly with manufacturers.
The understated tone was noticed by members. Rep.
The bill, which does not include a funding mechanism, also would preserve health care and medical benefits from the Veterans Administration and Indian Health Service, and give consumers two years to phase in to the program.
"It's thoughtful. People aren't grandstanding", the Florida Democrat said. Because of the disease, Barkan, who is wheelchair bound, will deliver his testimony using a system that converts his eye movements into speech. Barkan told the panel his family pays $9,000 each month for the almost 24-hour home care he needs, rather than moving him into a nursing home away from his wife and son. McGovern said he is a strong supporter of the Medicare-for-all bill introduced by Reps. Setting higher provider payments and gradually reducing them to Medicare FFS rates, for example, would mitigate negative impacts on provider income - but it would also create higher costs for government. "Our time on this earth is the most precious resource we have".
The CBO noted in its report that in the United States public programs haven't employed utilization management technology, but private insurers have lowered costs with those systems.
As McGovern, the rules chairman, pointed out, Tuesday's hearing is Congress's first on legislation called Medicare-for-all, which he called historic. "I'm less concerned with where we start then where we finish up".
Even so, this week's developments, including Biden's embrace of a public option, are a sign of how dramatically the health care landscape has changed since the Affordable Care Act was being debated a decade ago. They hope they can stoke fear of a government takeover of health care that will work to their advantage in the next election.
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The list of other witnesses for Tuesday's hearing included experts from the Commonwealth Fund, the Center on Economic and Policy Research and the National Medical Association. It would provide coverage for newborns, who would be automatically enrolled in the program, uninsured Americans and those now on Medicare, Medicaid and Obamacare plans.
But Republicans are certain to find ammunition in the report for their criticisms of a single-payer system.
Gaffney, a critical care doctor and instructor at Harvard Medical School, said he's anxious Democrats could "veer away from policy towards political expediency". "We must do more, which is why I believe it is no longer a matter of if we will have a single-payer health care system in our country, but when. It's a conversation that the country needs to have right now".
The hearing will be livestreamed on the House Rules Committee website.
That would follow a report expected to be released Wednesday outlining the key design components and considerations of a single-payer system, which will likely shape that panel's hearing.
The United States spends far more per capita on health care than any other nation; however, 34 million Americans do not have health insurance, thousands of people die each year because they can not afford medical care, almost one in three adults with insurance have been unable to afford the care they need and nearly half fear bankruptcy in the event of a health emergency.
"All are improvements over where we are today", the Colorado Democrat said.
More than a decade later, President Jimmy Carter signed the convenant, but the USA never joined the almost 170 countries, including most democracies, that ratified it.
The tax-writing Ways and Means Committee, along with the Energy and Commerce Committee, with its jurisdiction over health policy, could also take up the topic later this year.
Their GOP colleagues on Ways and Means wrote a letter to Chairman Richard E. Neal asking for a hearing on the issue.