Medicare for All and Public Option are federal programs aiming to widen the reach of quality, affordable healthcare for Americans. Approval has not yet been given for either program, but both have their own benefits.
Healthcare reform is a hot topic, and during a presidential election year, it remains at the forefront.
Currently, Medicare is available only to adults aged 65 and over, or those with specific medical conditions.
The idea of Medicare for All began with the idea of creating a program that would give access to quality healthcare that everyone can afford.
Public Option is another federally funded healthcare program.
Politicians have submitted the proposal Public Option more than once, and each proposal has seen the inclusion of different benefits.
Below, we learn more about Medicare for All and Public Option and how they compare to each other.
We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan:
- Deductible: This is an annual amount that a person must spend out of pocket within a certain time period before an insurer starts to fund their treatments.
- Coinsurance: This is a percentage of a treatment cost that a person will need to self-fund. For Medicare Part B, this comes to 20%.
- Copayment: This is a fixed dollar amount that an insured person pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Medicare for All would expand on the healthcare coverage that is already offered by original Medicare.
Currently, Medicare consists of different parts, each providing coverage for different healthcare needs.
Original Medicare includes:
- Part A: inpatient hospital care, such as nursing care, semi-private rooms, and skilled nursing care
- Part B: diagnostic tests, treatment as an outpatient, some preventive care services, and limited prescription drugs
- Part C: an optional Medicare Advantage plan, which provides coverage through private insurance companies, instead of opting for original Medicare
- Part D: a prescription drug plan for the most commonly prescribed medications, also offered by private insurers
- Medigap: optional help with the costs of Medicare copayments, coinsurance, and deductibles, involving a monthly premium
Medicare for All would include the coverage that is currently provided by parts A, B, and D.
It would also provide more essential health coverage that is not currently offered through original Medicare.
The extra coverage could include:
- pediatric care
- maternity and newborn care
- reproductive care
- long-term care
- vision care
- hearing aids
- short-term rehabilitation services
Currently, original Medicare has a deductible, copayment, and coinsurance that applies to some services.
Under Medical for All, a person will not share costs. There would be no deductible, copayment, or coinsurance to pay, except for in specific situations.
Benefits of Medicare for All
Everyone’s healthcare needs are different, but the benefits of Medicare for All include:
- Cost: A person will not pay upfront costs in deductibles or copayments.
- Increased coverage: Medicare for All gives a broader range of care and meets more healthcare needs than original Medicare.
- Decreased fear of losing coverage: Since Medicare for All does not depend on a person’s employment status, changing or leaving a job would not affect coverage.
Public Option is also a government-funded healthcare program.
Opting for healthcare coverage through Public Option is different from having private health insurance.
It is an alternative program that a person can choose, but it is not a requirement.
The specific funding for Public Option has not yet been decided.
Discussions have included a tax-funded program or a program that is individually funded when a person first enrolls.
Like Medicare for All, Public Option would cover essential healthcare needs, including:
- inpatient hospital care
- outpatient care, such as preventive, diagnostics, and treatment
- pediatric care
- maternity and newborn care
- substance misuse care
- prescription drugs
Benefits of Public Option
Public Option talks continue to take place. Because of this, there is no final confirmation of the specific program benefits.
However, possible benefits may include:
- Cost: Public Option will likely cost less than private insurance plans.
- Accessibility: Public Option is an alternative to health insurance. How a person will qualify is not known, but anyone who wanted to opt-in, likely could.
- Drive down costs: Since Public Option could create more choices for individuals, there could be a decrease in the cost of private health insurance. This would be due to a rise in marketplace competition.
Similarities exist between Medicare for All and Public Option.
Both programs have a goal of offering accessible, quality healthcare at lower costs.
- Both programs aim to offer healthcare to those that do not qualify due to employer restrictions.
- Both plans provide coverage for those with preexisting conditions.
- Both programs aim to make healthcare available to those who may not otherwise be able to pay for it.
Although similarities exist, there are also differences between both programs.
Public Option may be individually funded at enrollment or tax-funded.
Medicare for All would involve an entirely government-funded and government-run program.
Public Option would still allow for health insurance availability through private companies.
Medicare for All would be the only option for healthcare and a person would not be able to purchase private health insurance.
All Americans qualify, and enrollment is automatic under Medicare for All. In contrast, individuals can choose to enroll in Public Option, but they do not have to.
A person may find the following side-by-side comparison helpful:
|Features||Medicare for All||Public Option|
|Essential healthcare covered, including hospital care, doctor’s visits, maternity care||yes||yes|
|Prescription drug coverage||yes||yes|
|Preexisting conditions covered||yes||yes|
|Competing plan available||no||yes|
Medicare for All is a government-run and government-funded healthcare coverage plan. It would eliminate the need for other health insurance.
Public Option is a tax-funded or individually funded health coverage program. A person would opt-in to the program and other health insurance plans would be available.
Both programs aim to have a positive impact on the quality of healthcare available.
Both intend to lower healthcare costs and provide increased accessibility for all Americans.
The programs hope to help those who cannot easily pay for their healthcare costs or those who do not qualify for insurance through their employer.
It is not yet clear if either program will be put into effect and the discussion on healthcare reform is likely to continue.