Rep. Morales introduces legislation to establish a statewide ‘Medicare for All’ health care system for the fourth year

STATE HOUSE – For the fourth consecutive year, Rep. David Morales has introduced legislation to establish a statewide universal, comprehensive single-payer health care program.

“Every year, thousands of working people and families across Rhode Island refrain from receiving the medical and dental treatment that they need because it is just too expensive. In other words, if people feel forced to delay medical care because of the associated costs, it is a clear sign that we need to radically transform our health care system,” said Representative Morales (D-Dist. 7, Providence). “Through a single-payer Medicare-for-all health care system we would be able to guarantee comprehensive health care coverage to all Rhode Islanders free of out-of-pocket expenses or co-payments, regardless of socioeconomic status. Health care is a human right and we cannot afford to wait for the federal government to act.”

The bill is scheduled for a hearing by the House Finance Committee today, Wednesday, May 22, at Rise of the House sometime after 5 p.m. in Room 35 in the basement of the State House.

This legislation (2024-H 8242) would create a “Medicare-for-all” style single-payer program that would replace multiple “middlemen” insurers with a single coverage provider, the Rhode Island Comprehensive Health Insurance Program.

The program would be funded by consolidating government and private payments to multiple insurance carriers into a more economical and efficient single-payer program and would replace high health insurance premiums, copays and deductibles with federal reimbursements and progressive taxes on large businesses.

Under Representative Morales’ bill most Rhode Islanders would pay less for health insurance and all Rhode Islanders would have access to comprehensive coverage that includes medical, dental, vision and mental health care, as well as lower-priced prescription drugs.

According to data from the Kaiser Family Foundation, in 2022 the average cost of an individual insurance plan in Rhode Island was $8,215 and the average cost of a family plan was $22,955. Employers on average paid about 75% of those costs and employees paid the other 25%, meaning the average employer paid between $6,000 and $17,000 per covered employee and the average worker paid between $2,000 and $6,000. Those costs do not include copays, coinsurance, deductibles or prescription copays, which can add up to thousands or even tens of thousands of dollars if individuals require care.

The program proposed by Representative Morales would be paid for primarily by a 10% payroll tax, with the employer responsible for 8% and the employee responsible for 2%. There would be no copays or deductibles, and prescription medicine would be free. Additional funding would come from federal Medicaid and Medicare reimbursements along with a 10% tax on unearned income, such as capital gains and dividends.

According to the Rhode Island Department of Labor and Training, the average private-sector salary in Rhode Island in 2022 was $64,542. That means that under the Medicare-for-All plan, the average employer would pay $5,163 per year and the average employee would pay $1,291 in total annual health care spending.

The savings come from efficiencies and reducing middlemen profits. Currently, a complex web of negotiations take place between health care providers, insurance companies and pharmacy benefits managers. Hospitals and medical clinics expend enormous resources contacting insurance companies and debating over payments owed. And insurance companies and PBMs are among the most profitable corporations in the entire country.

“Too many Rhode Islanders know from experience that our current for-profit health care system benefits CEOs and corporate stockholders at the expense of patients, health care workers and our community,” said Representative Morales. “Too often, medical, dental and vision care is exclusive, expensive or accessible to only the fortunate, but it doesn’t have to be. If we take this basic human right back from the companies profiting at our expense, we can build a guaranteed health care system accessible for everyone.”