This story was reported and written by our media partner the Virginia Mercury.
One of Chesterfield County resident John Meszaros’ sons was born with a rare metabolic syndrome, which required frequent doctor visits in his first year of life and came with hefty hospital bills at the start of it.
Though his son is now covered by Medicaid, Meszaros said he and his wife have had to make numerous calls with the hospital and their insurer over the past year to sort through their son’s critical early healthcare.
“It just adds a lot of aggravation into our lives,” he said, noting that the experience highlighted his desire for universal healthcare.
He also recalled a trip to the emergency room during a medical emergency when he was a college student, where “while I was in the gurney, they were asking me for payment — no joke.”
“Medicare for All” was the key pillar of former 1st Congressional District Democratic hopeful Salaam Bhatti’s campaign, which clinched Meszaros’ vote in the primary.
The concept would replace private insurance companies with government-run health insurance available to everyone.
While living abroad in Scotland for a year, Bhatti recalled not having to pay a co-pay during a doctor visit.
As he monitored how other countries have some form of universal healthcare he recalled thinking: “you can actually invent a policy that really helps people from a root level.”
Bhatti came in 2nd in the crowded primary and current Democratic nominee Shannon Taylor is facing off against longtime incumbent Rob Wittman, R-Westmoreland, in what’s emerged as one of Virginia’s — and the nation’s — “toss-up” districts this year.
Though Taylor has not spoken about universal healthcare, and did not respond to The Mercury’s inquiry about it, Meszaros is glad to know she has expressed support forundoing Medicaid changes and restoring ACA subsidies.
“Medicaid is already tricky and (Congress) made it harder,” Meszaros said of the reconciliation bill Congress passed last summer that altered it. “(Republican majorities) want to kick people off as far as I can tell.”
But beyond immediate suturing of healthcare cuts, any potential overhauling of America’s healthcare system will take time and political buy-in, U.S. Rep. Don Beyer, R- Alexandria, said.
The six-term congressman, who is running for reelection, was among 118 co-sponsors of last year’s Medicare For All Act, a measure that didn’t advance after its introduction.
Of the House’s 435 members, that cosponsorship represents nearly 30% of the chamber interested in universal healthcare.
U.S. Sen. Bernie Sanders, an independent from Vermont, has long championed the concept in Congress’ other chamber.
This year, Virginia’s own Sen. Mark Warner — a Democrat up for reelection, running against Republican Bert Mizusawa — told The Mercury he would support universal healthcare as well.
“We will never get to cost containment or improve quality as long as we’re arguing about who gets covered,” Warner said.
Beyer, Warner and Bhatti all noted how even if Democrats flip the House and Senate, with President Donald Trump still in the White House for another two years, a total shift to universal healthcare may not yet be feasible.
In that time, Warner suggests Congress explore what works for other countries that have universal healthcare to help shape America’s potential version.
“I want to start working on what a uniquely American universal coverage system can be, with the goal of building consensus and have policy ready to go,” he said.
As a stopgap solution, Warner unveiled a bill package that would tackle the Medicaid and ACA revisions his party has sought, bolster pricing transparency for insurers and expand Medicare’s drug price negotiation program.
A ‘patchwork’ of policy and ideas
Currently, many Americans get their healthcare coverage through their employers, who contract with private insurers.
Others purchase plans through the ACA marketplace.
Disabled and pregnant people, along with some eligible low-income people, get coverage through Medicaid — a joint state and federal program.
A disruption is already underway for both Medicaid and ACA since Congress let subsidies for the latter expire and adopted changes that may lead to millions of Americans losing Medicaid eligibility.
Matthew Fiedler, interim director of the Center on Health Policy at the Brookings Institute, called America’s healthcare landscape a “patchwork.”
The difficulty in navigating it is why he surmises constituents and lawmakers alike are flirting with the single-payer system Medicare for All would represent.
But, he said, it would mean “shifting a lot of private healthcare spending into the government’s balance sheet, it’s going to be disruptive.”
Private insurance companies haveopposed the idea, because a true single-payer system would put them out of business.
Additionally, higher taxes could be part of that equation, he suggested, to ensure coverage for everyone. However, the government would be able to negotiate or set prices for services, prescriptions or hospital budgets.
Like Warner, Fiedler also pointed to different pathways to universal coverage that other countries have taken that could be used as reference points.
Some countries have single-payer models while others have tightly regulated private insurers with universal coverage mandates, a contrast to how U.S. insurers don’t cover everyone.
“Some countries have employers contribute a portion of wages for health care, like we do for Medicare now. Some countries make decisions at the national level. Others have more local governments, or a mix,” Warner said.
Analysts stateside have also laid out blueprints for incremental steps to universal coverage. The Urban Institute, for example,suggested enhancing cost-sharing subsidies and capping provider rates, among other steps.
The results of Tuesday’s midterm elections could have direct implications on Congress’ approach to new healthcare policy. Two-thirds of Americans support Medicare for All,according to a new KFF poll.
Amid the fallout from the Republican-controlled Congress’ healthcare actions in the past year, Democratic candidates have focused their campaigns on making care accessible and affordable for all citizens.
As Republicans attempt to hold their majorities and Democrats attempt to flip the chambers’ control, it still may be a couple of years before universal healthcare talks become more than campaign promises.
It can’t come too soon for people like Meszaros, or others who fear bankruptcy due to medical debt or delay care because they’re under-or-uninsured.
“Something is not quite right here,” Meszaros said.