On April 30, the House Rules Committee held a hearing on the Medicare for All Act of 2019, the first committee to hold a hearing on the topic despite Energy and Commerce and Ways and Means having primary jurisdiction over the majority of health care issues. During the hearing, news broke that the Ways and Means Committee would hold a hearing on single-payer health care, although the hearing will focus broadly on the topic instead of the Medicare for All legislation specifically. Democrats on the committee used the hearing to make moral arguments in favor of the broad goal of coverage expansion while Republicans slammed its supporters for trying to upend an entire system instead of building on what works.

Testifying at the April 30 hearing were witnesses from the Center for Popular Democracy, Center for Economic and Policy Research, Commonwealth Fund, National Medical Association, Galen Institute and Mercatus Center, and a physician advocate for a national health insurance program. The Democratic witnesses expressed support for Medicare for All, focusing on the cost savings to the American people through the elimination of out-of-pocket costs, streamlining of administrative costs across the system, and provision of high-value, preventative care. The economists in the group also noted that the degree of potential savings and efficiencies are highly dependent on the ability of a plan to lower provider payments, and costs for prescription drugs administration. On the Republican side, witnesses discussed the estimated $32 trillion price tag for enacting the legislation over the first ten years and said health care expenditures would increase due to coverage of the uninsured, additional covered services, and added consumption due to complete first-dollar coverage of all individuals' health services, necessitating provider cuts and other payment mechanisms. They acknowledged that the current system has flaws but said the solution should be more targeted and should empower consumers and build on what works, such as the employer-sponsored system and other mechanisms that encourage innovation and popular private-sector plans such as Medicare Advantage (MA). They also discussed how single-player plans failed in Colorado and Vermont due to the difficulty of upending the current system and concern about additional taxes.

For more details, see the attached Tax Alert or click here.

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Rules Committee Hearing on Medicare for All