Healthcare Reform Proposals


A number of proposals to expand access to affordable healthcare will be introduced and debated in the 116th Congress.  This includes “universal healthcare” proposals to expand public healthcare options.  Disability advocates must continue to educate Congress about the services that people with disabilities need – long-term services and supports (LTSS), particularly Home and Community Based Services (HCBS) – to ensure they are included in any healthcare proposals being considered.


For the last several years, the disability community has fought attempts by Congress to cut Medicaid and repeal the Affordable Care Act (ACA).  In the 116th Congress (that began in Jan. 2019), we expect to see both the Senate and House introduce universal healthcare proposals expanding the public healthcare options for all Americans.  So far, these bills have ranged from “Medicare for All” to Medicaid Buy-in programs.  A discussion about improving access to healthcare is underway.  At the same time, the ACA continues to be at-risk, and even with the ACA, millions remain uninsured, and costs and deductibles can remain unaffordable for those with coverage.

Specific Proposals

In the 116th Congress

Medicare for All (H.R. 1384) was introduced on Feb. 27, 2019 by Rep.  Jayapal.  Here’s a 2 page summary and section by section summary explaining some of the key provisions.  

Key proposals and bills in the last Congress

  • Medicare for All (House and Senate):  single payer system proposed, (S.1804H.R. 676 in the 115th Congress)
  • Medicare for America (House):  expanded federal program with private employer insurance  (H.R. 7339 in the 115th Congress)
  • Medicaid Buy-in (House and Senate):  option for additional people to buy into Medicaid through the ACA marketplace proposed in the 115th  (S. 2001H.R. 4129 in the 115th Congress).
  • Medicare expansion (House and Senate):  lowering age to qualify for Medicare with buy-in (S. 1742H.R. 3748  in the 115th Congress)
State -Based Healthcare Expansion Proposals


CCD Disability Principles for Inclusion of Long Term Service and Supports (LTSS) in Universal Health Care, Consortium for Citizens with Disabilities

Medicare-for-All and Public Plan Buy-In Proposals: Overview and Key Issues, Kaiser Family Foundation (10/9/18)

Primer on the Medicare-for-all Debate, Kaiser Family Foundation (2/19/19)

The Only Guide to ‘Medicare for All’ That You Will Ever Need, Splinter (2/14/19)

The Landscape of Federal and State Healthcare Buy-In Models, Manatt (Feb. 19)

Single Payer Getting More Attention at State Level, Not Going Away, HealthLeaders (7/18/18)

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