Bernie Sanders kicks off Medicare for All proposal; Harris, more on board

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WASHINGTON – With California Sen. Kamala Harris and a handful of other liberal senators often viewed as the Democratic Party’s next generation of leaders lined up in support, Sen. Bernie Sanders introduced a plan Wednesday for a government-run health care system he called Medicare for All.

The proposal, which Sanders, independent-Vt., introduced to a packed audience in the Senate’s largest hearing room, comes as several Senate Republicans are attempting to revive their party’s floundering effort to repeal and replace the Affordable Care Act with a new plan that would provide states with lump sums of federal money to provide health care. Each state would have the discretion to determine how to use the grants for that purpose.

The two efforts represent polar opposite approaches to addressing the high costs of health insurance. Sanders’ plan, in a Congress controlled by Republicans, stands little chance of success, but the support it is getting from Democrats is considered strong for an issue that had been considered on the fringes as late as last year, during the presidential race.

Harris said she was standing with her colleagues to “just do what’s right,” but also characterized her support as a nonpartisan effort to help all Americans, regardless of party, and at the same time increase the “return on investment” of the money taxpayers and individuals are already spending on health care.

The Sanders legislation, modeled on the so-called single-payer health care systems typical of most developed countries, calls for a complete remaking of the U.S. health care system. The 94-page bill provides only an outline of what would be an enormously complex undertaking that would meld the current hybrid U.S. system of both private and public insurance programs into a single system administered by the federal government.

Sanders called the lack of universal coverage in the United States an “international disgrace.” He said the United States spends twice as much money, about $10,000 per person, as most other industrialized countries do on health care, and leaves both patients and providers saddled with mountains of insurance paperwork. Sanders said studies show the U.S. could save $500 billion a year by eliminating the insurance-company middlemen.

The legislation would eliminate employer-provided insurance, which currently covers 155 million people and is the foundation of the current U.S. system. It would replace that private insurance with government-provided care. The plan would also replace a welter of government-operated health care programs, including Medicare, the giant program for the elderly, and Medicaid, which provides health care to the poor and working class. Those would be folded into a single system that would cover every U.S. resident.

The legislation leaves unclear how to fund such a program, one of the most salient questions facing such a plan. Sanders provided a separate paper outlining possible revenue sources, including higher taxes on high-income earners and also much broader-based taxes, such as a 7.5 percent employer-paid payroll tax, or a 4 percent tax on individuals based on income.

Sanders argued that the savings that families and businesses would see from not having to pay for health insurance would more than offset such tax increases. He called the proposal only “the beginning of the debate” on how to transition the United States to a single-payer system.

Sanders’ proposal drew support from 15 Democratic senators in addition to Harris. They included Elizabeth Warren of Massachusetts. Harris, Cory Booker of New Jersey and Kirsten Gillibrand of New York are considered rising stars in the Democratic Party.

More than 100 House Democrats have signed on to a similar proposal in that chamber. House Minority Leader Nancy Pelosi of San Francisco has applauded the effort but said she remains committed to preserving the Affordable Care Act, enacted in 2010 under President Barack Obama to expand insurance coverage.

Sanders argued that the United States should have switched to a single-payer system decades ago. But many Democrats remain leery of his proposal, given the enormousness of the enterprise in cost, complexity and political peril.

Carolyn Lochhead is the San Francisco Chronicle’s Washington correspondent. Email: clochhead@sfchronicle.com

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