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Here's the real impact of Bernie Sanders’ unlikely 'Medicare for all' plan

  • Bernie Sanders introduced the 'Medicare for All' act, meant to phase in a single-payer health plan.
  • Of course, it has no chance of passage - at least not yet.
  • What's key though, is that it gives Democrats a singular message on health care going forward, and one that is gaining in popularity.

There was a time—just a few months ago, though it feels longer—when health-care reform was at the center of all political discussions. But after several failed attempts to repeal and replace the Affordable Care Act (ACA) it seemed that, as Paul Ryan once said, Obamacare would be the law of the land.

Hold that thought.

In recent weeks, we've seen the release of two new health-care proposals, one from each side of the aisle. The Republican plan, put forth by Sens. Lindsey Graham and Bill Cassidy, with support from the likes of fellow Sens. John McCain and Dean Heller, seems more or less like a revisit to previous plans that failed this summer. But Sen. Bernie Sanders' single-payer proposal could be a game-changer – even if it's equally as unlikely to become law.

Inside the Sanders bill

Bernie Sanders may not have come away from the 2016 presidential election with the Democratic nomination, but his impact is still being felt throughout the party. The latest instance is the Medicare For All Act, which would give every American access to the same insurer: The U.S. government.

The impact on the average consumer can't be understated – or definitively predicted. That's because Sanders' legislation is so wide-reaching it's hard to compare to existing single-payer systems. The bill lowers the age for Medicare qualification from 65 to 55 in its first year, then gradually phases everyone in over the next three. Coverage would include everything from hospital stays to prescription drugs and even vision and dental care – more than other countries offer their citizens – with few out-of-pocket costs.

So how does a country pay for full coverage at essentially no cost to recipients? That's a good question, and one that isn't answered in the bill. Sanders has released different financing options, all of which boil down to increased taxes for various groups. While the Congressional Budget Office hasn't yet scored the plan, proponents argue that, for the average American, the money saved on health care costs would outweigh any unavoidable tax increase. But even if there was a net increase, would saying goodbye to confusing health insurance bills make up for it?

The bill has the opportunity to lower the uninsured rate to zero. Nearly half of Senate Democrats have co-signed it. What it doesn't have is a chance of becoming law – yet.

Medicare for all, supported by some

Not everyone is on board with Sanders' plan. Republicans obviously aren't. A number of Democrats are waiting to digest the bill before making a decision. Former Secretary of State and presidential candidate Hillary Clinton said in an interview that she would support lowering the age needed to qualify for Medicare or Medicaid now and then suggested the U.S. could take incremental steps towards a single-payer system.

The Medicare For All Act will almost certainly not pass for several reasons, not the least of which being that Democrats don't control the House of Representatives or the Senate and there's no outline to pay for it. But it might not have to become a law as long as it becomes a path forward.

Like same-sex marriage before it and marijuana legalization currently, a single-payer healthcare system has seen a slow but steady rise in public support. According to the Kaiser Family Foundation, favor for a single-payer healthcare system has risen from 40 percent in 2000 to 46 percent in 2008 to 53 percent as of June 2017. Throughout that time, fringe players like Sanders have been its greatest champions.

Now, though, several of the Democrats supporting a single-payer system are 2020 presidential hopefuls. As the failures of Obamacare are highlighted, and the failures of proposed Obamacare replacements even more so, alternatives once considered extreme are becoming mainstream. While Kaiser notes support of single-payer is "malleable" – survey respondents become less enthused when reminded of accompanying tax hikes, a hurdle Sanders' plan (and any other) will have to overcome – the Medicare For All Act could become an important foundation for future plans that shift further left.

So will the Medicare For All Act become law? No. Even co-signer Al Franken called the bill "aspirational" and "a starting point" in a Facebook post. But that doesn't matter. What matters is that, as Republicans present another plan consisting of block grants and pre-existing condition waivers, Democrats have begun to put forward a singular, comprehensive approach to health care – even if it has to wait.

Commentary by Jennifer Fitzgerald, the CEO and co-founder of PolicyGenius, an independent digital insurance company for consumers. Previously, she was a junior partner at McKinsey & Company where she advised Fortune 100 financial services companies on marketing and strategy. She is a graduate of Columbia Law School and Florida State University. Follow her on Twitter @jenlfitzgerald.

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