Medicare For All Versus Affordable Care Act and Public Option


The 2020 Presidential election has shown some serious fault lines in the Democratic party. The main cleavage in the party has been over healthcare. Some candidates, like Joe Biden, wish to preserve the existing Affordable Care Act, or Obamacare as it is popularly known. Others, like Pete Buttigieg, would prefer a “public option,” which would preserve existing insurance companies while also offering a public, government plan.

The Democratic frontrunner, Bernie Sanders, champions a policy called “Medicare for All,” which would eliminate private health insurance and cover every citizen with a comprehensive health plan. In essence, all people would have health insurance rolled into their taxes, and no one would pay any money out of pocket for their medical expenses.

Existing System: Affordable Care Act

The existing system, the ACA, has been the US’s healthcare system since it was signed into law during Obama’s first term. Under this type of healthcare system, people can either have their own private insurance, normally provided through an employer, or they can choose an insurance plan from the “healthcare marketplace” during open enrollment.

This also includes Medicare enrollment, which is meant to offer affordable Medicare insurance to people over 65. The name “Medicare” is used by politicians when discussing “Medicare for All,” but this might be a bit of a misnomer. In the case of Bernie Sanders’ proposed plan, unlike Medicare, his “Medicare for All” would cover everyone at no cost to themselves.

Public Option vs Medicare for All

More centrist candidates like Pete Buttigieg prefer a mixed system called the Public Option. This would preserve existing insurance companies and keep private health insurance around as an option. At the same time, a government program would compete with private insurance, which would be available to all citizens.

The argument for the public option is that it would be more realistic or easier to get passed through the House and Senate than a more sweeping, reform-minded plan like Medicare for All. However, with Sanders surging through the primaries, there is a distinct likelihood that his vision of everyone being covered under a comprehensive government plan could become reality soon.