Senator Sanders released his updated Medicare-for-all bill yesterday. Below is a simple summary of the general contents of the proposal.

Coverage Areas

The bill requires coverage of hospital services, ambulatory patient services, primary and preventive services, prescription drugs, medical devices, mental health services, substance abuse services, laboratory and diagnostic services, reproductive care, maternity care, newborn care, pediatrics, dental, vision, and short term rehabilitative services. Notably, the bill does not include long-term care, but Sanders has reportedly said long-term care would be handled in a separate bill.

This is a generous coverage universe, but it is not unheard of. Critics tend to roll their eyes at the inclusion of vision, dental, and prescription drugs. But Denmark’s public system covers all of those areas with some cost-sharing.

Cost-Sharing

The bill forbids cost-sharing for anything but prescription drugs. This means that there would be no deductibles, no coinsurance, no copayments, or other kinds of out-of-pocket expenses. The details of the prescription drug cost-sharing are mostly left to the regulators to work out, but there is a requirement that no individual be subjected to more than $250 of cost-sharing in a given year.

Transition

Those under the age of 19 would be enrolled immediately into the Medicare system. These individuals would be allowed to maintain their private health insurance in addition to their Medicare coverage during the four-year transition period. After that transition is over, there is a provision forbidding private insurance from duplicating the coverage provided by Medicare, which would effectively kill off any private insurance maintained by children up to that point.

For those over the age of 18, eligibility to enroll will be phased-in over four years. After year one, those 55 and over will be eligible. After year two, those 45 and over will be eligible. After year three, those 35 and over will be eligible. And after year four, everyone will be eligible. During that four-year period, adults will also have the ability to buy in to Medicare on the exchanges or if their employer chooses to offer it as an option.

Funding

The bill would bring in existing federal expenditures on healthcare made for Medicare, Medicaid, the Federal Employee Health Benefits program, TRICARE, and other smaller programs.

In addition to the bill, Sanders released a paper with tax proposals that are intended to provide the remainder of the funding. The proposals are: