Left-Leaning Think Tank Proposes Universal Healthcare Plan

A liberal think tank released a universal healthcare plan Thursday modeled on Medicare that would also preserve employer-based insurance coverage as an option for those who are satisfied with their current plans.

The Center for American Progress (CAP) is calling its program “Medicare Extra for All” and said it would be available to everyone regardless of income, health status, age, or insurance status.

In concept, the plan is somewhat similar to "Medicare for All" from Senator Bernie Sanders, I-Vermont, except the plan from the former presidential candidate would end any private coverage.

CAP envisions Medicare Extra administered by a new, independent Center for Medicare Extra within the current CMS, which would be renamed the Center for Medicare, with different groups being phased in over an 8-year period.

“Healthcare is a right, not a privilege,” Neera Tanden, president and CEO of CAP, said in a statement. “The Affordable Care Act was an historic accomplishment and a giant step toward universal health coverage. The sustained political fight over the law shows that Americans want to expand coverage, not repeal it. Medicare Extra would take the next step by guaranteeing the right of all Americans to enroll in the same high-quality healthcare plan. It is time to guarantee universal coverage and health security for all Americans.”

Medicare Extra includes additional benefits to the current Medicare program, such as an out-of-pocket limit, coverage of dental care and hearing aids, and integrated drug benefits. Medicare Extra would eliminate underinsurance, offering coverage with zero or low deductibles, as well as free preventive care and generic drugs. CAP also said treatment for chronic disease would be free.

Premiums would be capped based on income to ensure affordability and handled automatically through the tax system.

• For families with income up to 150% of the federal poverty level (FPL), premiums would be $0.
• For families with income between 150% and 500% of FPL, caps on premiums would range from 0% to 10% of income.
• For families with income above 500% of FPL, premiums would be capped at 10% of income.

The average share of costs covered by the plan, or “actuarial value,” would also vary by income.

For individuals with income below 150% of FPL, the actuarial value would be 100%—meaning these individuals would face 0 out-of-pocket costs. The actuarial value would range from 100% to 80% for families with middle incomes or higher.

CAP would set deductibles, copayments, and out-of-pocket limits that would vary by income. For individuals with income below 150% of FPL and lower-income families with incomes above that threshold, the deductible would be set at $0.

Medicare Extra would be financed by a combination of healthcare savings and tax revenue options. CAP said it intends to "engage an independent third party to conduct modeling simulation to determine how best to set the numerical values of the parameters." CAP said adopting Medicare’s pricing structure to restrain prices is “an essential part of financing universal coverage.”

The plan would negotiate prescription drug prices by giving preference to drugs whose prices reflect "value and innovation."

It also said Medicaid and the Children’s Health Insurance Program would be integrated into Medicare Extra, with the federal government picking up the tab. This way, health coverage for low-income individuals would be set across the country, the proposal said, and not subject to state decisions.