Bernie' recently introduced "Medicare for All" bill is not Medicare at all. It is more like a universal national insurance plan (similar to what I'd like to see), but calling it Medicare is misleading, a branding fail, bad optics, and a non-starter politically. He is playing on public misconceptions that Medicare is free healthcare. He also doesn't say specifically how to pay for it, other than a laundry list of possible taxes on employers and the wealthy.

I work for the Federal government. We have a plethora of plans to choose from, so my employer doesn't exactly choose my health insurer for me. I have Blue Cross which I like. I'd have to see what the replacement was before I could decide whether I like this plan or not. I like Mayor Pete's proposal: "Medicare for all who want it".

Medicare for All

It's driving me crazy when presidential candidates talk about Medicare for All as if it is free. Maybe one or two agreed that taxes would increase to pay for Medicare for All (Universal Health Care).

Currently, every person that works for a paycheck pays a Medicare tax. It doesn't matter how much you make, you pay the Medicare tax. However, if you make more than a set amount, you pay even more.

The Medicare tax is current 2.9%, where the employee has 1.45% deducted from their pay and the employer pays an additional 1.45%. You could pay an additional 0.9% if you make $200,000 and are single, $250,000 if you are married and filing jointly, or $125,000 if you are married and filing separately.

This current Medicare tax is to pay for Medicare for Senior citizens, disabled people, and a couple of other categories. Thus, if we are going to provide Medicare for All, you would think this tax will have to increase.

In 2020, Medicare enrollment will reach approximately 64 million. One in six beneficiaries qualified for Medicare coverage in 2011 before turning 65 on the basis of permanent disability. Currently the U.S. population is approximately 330 million. Thus, to provide Medicare for All (Universal Health Care) and take away all private health insurance options, there will be approximately an additional 266 million people to cover.

There are a lot of variables and costs when it comes to Medicare. I wonder which parts (some or all) are these presidential candidates offering when they say Medicare for All (Universal Health care), especially when they say it will be free.

Check it out at medicare.gov.

Medicare costs, in addition to the Medicare tax:

Medicare Part A Premium - $0.00 (eff. 2019)
Unless you paid Medicare taxes for less than 40 quarters, then you would have to pay $437/month if you paid Medicare taxes for less than 30 quarters or $240/month if you paid Medicare taxes for only 30-39 quarters. Also, if you do not sign up for Medicare when you are supposed to you there can be an additonal monthly premium to pay.

Medicare Part A Deductible - $1,364/annually (eff. 2019)

Medicare Part A Coinsurance - $0/day to $341/day to $682/day or all costs/day (eff. 2019)
The higher coinsurance is only if you are in the hospital for 61 + days ($341/day), for 91 + days ($682/day) or all hospital costs if you go over the lifetime reserve days. If you elect to go with a Medicare Supplement private insurance policy or Medicare Advantage private insurance policy, the private insurance policies will probably cover the coinsurance. Of course, you may have to pay an additional insurance premium for the private insurance policies or have other deductible/co-payments/coinsurance.

Medicare Part B Premium - $135.50/month (eff. 2019)
Unless you don't sign up for Part B when you are eligible, then you pay a penalty and will have to pay this penalty for as long as you have Part B. Also, if you made above a certain amount prior to going on Medicare you will have an extra charge added to the Part B premium. For example, if you are single and made above $85,000 or if you are married filing jointly and made above $170,000 you will pay an additional $54.10/month.

Medicare Part B Deductible - $185/annually (eff. 2019)
After your deductible is met, you typically pay 20% of the Medicare-approved amount for most doctor services (including most doctor services while you’re a hospital inpatient), outpatient therapy, and durable medical equipment. If you elect to go with a Medicare Supplement private insurance policy or Medicare Advantage private insurance policy, the private insurance policies will probably cover the 20%. Of course, you may have to pay an additional insurance premium for the private insurance policies or have other deductible/co-payments/coinsurance.

Above are the basic Medicare benefits provided by the U.S. government based on the Medicare tax and monthly premiums and coinsurance, deductible, etc.
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To get additional benefits you currently have to purchase private insurance.

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Medicare Part D - $??.??/month (eff. 2019)
Medicare Part D is for prescription drug coverage. This is purchaed through a private insurance company and the monthly premiums vary greatly. The monthly premiums can vary based on location, age, provider, etc. There will likely also be deductibles, coinsurance and/or co-payments. If you elect to go with a Medicare Advantage plan, not original Medicare, drug coverage is usually included in the Medicare Advantage plan that is also purchased through a private insurance company.

Medicare Supplement Insurance (Medigap) - $??.??/month (eff. 2019)
Medicare Supplement Insurance (Medigap) private insurance policies help pay some of the health care costs that Original Medicare doesn’t cover, like Copayments, Coinsurance, and Deductibles. You must have Medicare Part A & B to purchase a Medigap policy. According to the Medicare.gov plan finder, Medigap policies in Knox County zip code 37920 policy premiums can range from $44/month to $371/month based on benefits, deductibles, co-pays, coinsurance, etc.

Medicare Part C (Medicare Advantage) - $??.??/month (eff. 2019)
Medicare Advantage (Part C) plans are offered through private insurance companies and approved by Medicare.
Before enrolling in a Part C plan, you must first enroll in Original Medicare — both Part A and Part B. Note, if you elect to go with a Medicare Advantage plan you will get all of your healthcare through the private insurer, you will not be using your Medicare card. According to the Medicare.gov plan finder, Medicare Advantage policies in Knox County zip code 37920 policy premiums can range from $0/month to $217/month based on benefits, deductibles, co-pays, coinsurance, etc.

And there are many more if/ands/buts to getting Medicare. Therefore, it is something that has to be considered in great depth to ensure the services are there and the money is collected to pay for it. With some of the optional plans (part D, Medigap, Advantage), you may have to change doctors/providers to be in the insurers network of providers.

New York Times: "As Democrats embrace the idea of expanding the federal health insurance program, we looked at what it covers and costs. It’s far from “free."

I don't have a good enough handle on health insurance to have a definitive opinion

But I do think the Affordable Care Act was a good effort in right direction. And I think moves like Rubio's have handicapped it's success maliciously.

Marco Rubio quietly undermines the Affordable Care Act