In Congress

MOST RECENT BILLS and Letters (selection) . . .

Bill of July 25, 2024 “To amend the Public Health Service Act... (Health Over Wealth Act)” (H.R.9156) – Rep. Jayapal et al., referred to 2 committees
Co-sponsors: (Dem) Balint, Hoyle, Norton, Pocan, Frost
Summary: unavailable as of Aug.3, 2024, but “would require greater transparency for private equity firms and for-profit companies that own health care entities, including hospitals, nursing homes, and mental or behavioral health facilities. The legislation would put safeguards in place to protect workers, patients, and health care quality, access, and safety; create stronger accountability measures for corporate greed; and close tax loopholes that benefit real estate investment trusts making money off of health care property.”
https://www.congress.gov/bill/118th-congress/house-bill/9156

Bill of July 25, 2024 “A bill to amend the Public Health Service Act... (Health Over Wealth Act)” (S.4804) – Sen. Markey et al., referred to Finance
Co-sponsors: (Dem) Baldwin, Welch, Merkley, Warren, Booker, Smith, Blumenthal; (IND) Sanders
Summary: unavailable as of Aug. 3, 2024, Senate version of H.R.9156
https://www.congress.gov/bill/118th-congress/senate-bill/4804/

Letter Feb. 29, 2024 from Reps. Jayapal, DeLauro, Schakowsky and 57 other representatives – all Democrats – to Pres. Biden, Sec. Becerra, and Administrator Brooks-LaSure calling for urgent reforms to Medicare Advantage, which is fraught with waste, fraud, and abuse, often sacrificing patient outcomes for higher corporate profit. 
"By strengthening Traditional Medicare and taking actions to protect beneficiaries from MA, CMS could save hundreds of billions of taxpayer dollars annually, money that could in turn be used to decrease the cost of Traditional Medicare for seniors and people with disabilities.  Calls on CMS to: (1) Ensure insurance companies do not prevent enrollees from getting care by putting up obstacles such as prior authorization, artificial intelligence (AI) algorithms, and limited networks; (2) Strengthen provider encounter and patient data collection and transparency; (3) Rein in overpayments to insurers by adjustment benchmarks and cracking down on deceptive tactics by private companies; (4) Strengthen Medicare through administrative actions, such as lowering Medicare premiums, and support legislative efforts to cap out-of-pocket costs and adjust the physician fee schedule to account for increases in provider costs.”
https://jayapal.house.gov/2024/02/29/jayapal-delauro-schakowsky-lead-effort-to-protect-enrollees-on-medicare-advantage/

Letter Jan. 26, 2024 from Rep. Jayapal and Sen. Warren to CMS urging for administrative action to curb billions in overpayments to Medicare Advantage insurers. 
"The MA program has jeopardized the solvency of Medicare’s Hospital Insurance Trust Fund, raised Part B premiums for all Medicare beneficiaries by as much as $140 billion over ten years, and created significant barriers to care for vulnerable enrollees. It is imperative for CMS to rein in these abuses and protect Medicare coverage for the seniors and people with disabilities who rely on it.” Needed: (1) address perverse incentives in MA’s payment system, including favorable selection and risk code gaming, (2) reform the flawed Quality Bonus Program, and (3) crack down on private insurers that unlawfully deny care.
https://www.warren.senate.gov/imo/media/doc/2024.01.25_Letter_to_CMS_on_Medicare_Advantage_overpayments.pdf

Bill of May 17, 2023 “Medicare for All Act of 2023” (S.1655) – Sen. Sanders et al., referred to Finance
Co-sponsors: (Dem) Baldwin, Blumenthal, Booker, Gillibrand, Heinrich, Hirono, Lujan, Markey, Merkley, Padilla, Schatz, Warren, Welch, Whitehouse
Summary: This bill establishes a national health insurance program that is administered by the Department of Health and Human Services (HHS). Among other requirements, the program must (1) cover all U.S. residents; (2) provide for automatic enrollment of individuals upon birth or residency in the United States; and (3) cover items and services that are medically necessary or appropriate to maintain health or to diagnose, treat, or rehabilitate a health condition, including hospital services, prescription drugs, mental health and substance abuse treatment, dental and vision services, home- and community-based long-term care [NEW from earlier Senate bill:] gender affirming care, and reproductive care, including contraception and abortions.
The bill prohibits cost-sharing (e.g., deductibles, coinsurance, and copayments) and other charges for covered services. Additionally, private health insurers and employers may only offer coverage that is supplemental to, and not duplicative of, benefits provided under the program.
Health insurance exchanges and specified federal health programs terminate upon program implementation. However, the program does not affect coverage provided through the Department of Veterans Affairs, TRICARE, or the Indian Health Service. Additionally, state Medicaid programs must cover certain insitutional long-term care services.
The bill also establishes a series of implementing provisions relating to (1) health care provider participation; (2) HHS administration; and (3) payments and costs, including the requirement that HHS negotiate prices for prescription drugs and establish a formulary.
Individuals who are age 18 or younger may enroll in the program starting one year after enactment of this bill; other individuals may buy into a transitional plan or an expanded Medicare program at this time, depending on age. The bill’s program must be fully implemented four years after enactment.
https://www.congress.gov/bill/118th-congress/senate-bill/1655

Bill of May 17, 2023 “Medicare for All Act of 2023”(H.R.3421) – Rep. Jayapal et al.,  referred to 7 committees
113 co-sponsors, all Democrats
Summary: mostly as S.1655, except for “...vision services, long-term care, gender...”; no mention of establishing a formulary; this paragraph: “Health insurance exchanges and specified federal health programs terminate upon program implementation. However, the program does not affect coverage provided through the Department of Veterans Affairs or the Indian Health Service”; and the last paragraph: “Individuals who are age 18 or younger, age 55 or older, or already enrolled in Medicare may enroll in the program starting one year after enactment of this bill; other individuals may buy into the program at this time. The program must be fully implemented two years after enactment.
https://www.congress.gov/bill/118th-congress/house-bill/3421/
See also: https://jayapal.house.gov/2023/05/17/jayapal-dingell-sanders-introduce-medicare-for-all-with-record-number-of-house-cosponsors/

Bill of May 12, 2022 “Medicare for All Act of 2022” (S.4204) – Sen. Sanders et al., referred to Finance
Co-sponsors: (Dem) Baldwin, Blumenthal, Booker, Gillibrand, Heinrich, Hirono, Leahy, Lujan, Padilla, Markey, Merkley, Schatz, Warren, Whitehouse
Summary: see S.1655 (2023) above, which is same except for highlighted bit.
https://www.congress.gov/bill/117th-congress/senate-bill/4204

Bill of March 17, 2021 “Medicare for All Act of 2021”(H.R.1976) – Rep. Jayapal et al., referred to 7 committees
122 co-sponsors, all Democrats
Summary: same as H.R.3421 above
https://www.congress.gov/bill/117th-congress/house-bill/1976


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SOME of the EARLIER BILLS . . .

April 2019 “Medicare for All Act of 2019” (S.1129) –Sen. Sanders, 14 co-sponsors, mostly matches H.R.1384
Text has never changed, but Politico reported in Aug. 2019 that Sanders said “companies with union-negotiated... coverage would have to renegotiate their workers’ contracts [to be overseen by Natl Labor Relations Bd] ... any resulting health care savings from the single-payer system would be required to be returned to workers in the form of higher wages or more generous benefits.”
Important differences (particularly on cost containment) described by Lambert Strether in Naked Capitalism:   Representative Jayapal’s bill, HR 1384, meets the definition of a single-payer bill as originally outlined in PNHP’s 1989 article and as most experts define the term. It contains the four elements of a single-payer system: It relies on one payer (HHS, not multiple payers called ACOs) to pay hospitals and doctors directly; and it authorizes budgets for hospitals, fee schedules for doctors, and price ceilings on prescription drugs.
Senator Sanders’ bill contains two of those four elements – fee schedules for doctors and limits on drug prices. That’s a good start. He should add the other two. He should get rid of Section 611(b), the section that authorizes ACOs, and thereby ensure HHS is the single payer. And he should add a section authorizing HHS to negotiate budgets with each of the nation’s hospitals.
https://www.congress.gov/bill/116th-congress/senate-bill/1129

Feb 2019 “Medicare for All Act of 2019” (H.R.1384) – Rep. Jayapal, 118 co-sponsors
         • establishes a national health insurance program administered by the DHHS
         • to cover all US residents with free health care (all spelled out)
         • terminates health insurance exchanges
         • establish implementing provisions relating to provider participation, admin, payments and costs,
           negotiating drug prices
         • be fully implemented in four years 
         https://www.congress.gov/bill/116th-congress/house-bill/1384


Sept 2017 “Medicare for All Act of 2017” (S.1804) – Sen. Sanders, 16 co-sponsors
         • establishes a national health insurance program to cover all US resident over
          specified items and services
         • be fully implement in four years 
         https://www.congress.gov/bill/115th-congress/senate-bill/1804/


Jan 2017 “Expanded Improved Medicare for All Act” (H.R.676) –Sen. Conyers, 124 co-sponsors
         • to cover all US residents with free health care (all spelled out)
         • only public or nonprofit institutions can participate 
         https://www.congress.gov/bill/115th-congress/house-bill/676


Dec 2013 “American Health Security Act of 2013” (S.1782) – Sen. Sanders, no co-sponsors
         • eliminates Titles XVIII (Medicare) and XIX (Medicaid)
         • repeals provisions of the AFA (the exchanges)
         https://www.congress.gov/bill/113th-congress/senate-bill/1782


Feb 2003 “U.S. National Health Insurance Act (or the Expanded and Improved Medicare for All Act)” (H.R.676) – Sen. Conyers, 38 co-sponsors
         • establishes a national health program for all US residents
         • various other stipulations changed since then
         https://www.congress.gov/bill/108th-congress/house-bill/676


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