Bill would create single-payer health care system in Michigan

A bill to be introduced in the Michigan House would transform the way the state approaches health care by creating a government-administered single-payer system to provide coverage to every Michigander.

The MiCare plan unveiled today by Rep. Yousef Rabhi (D-Ann Arbor) would provide state residents with comprehensive care, including dental, mental health, and prescription drug coverage while eliminating health care premiums, co-pays, and deductibles.

"We've suffered long enough under a system that puts families in a position where they have to choose between medical care and going bankrupt," Rabhi said before taking to the steps of the Michigan Capitol this morning to announce details of his proposal. "It's not acceptable to live in a society like that."

The plan — which Rabhi says will result in $20 billion in net savings to the state — would be paid for by cutting administrative costs generated by for-profit insurance companies and raising taxes on the state's top earners. A separate to-be introduced funding bill would create a graduated income tax, capital gains tax, and payroll tax to pay for the program. Employers would pay into the system via that payroll tax, but Rabhi says their contribution would be less than the average $5,500 contribution per single employee they pay currently. Under the progressive tax structure Rabhi envisions, only the top 6 percent of earners would see an increase above what they already pay for health coverage. The funding bill would require legislative and voter approval.

"It makes fiscal sense," Rabhi says. "When you're talking about a public single-payer health care system, you're talking about a reduction in administrative costs of 80 percent. That money is currently going to corporate profits, CEO pay, to administer all these different health insurance companies — [our plan] doesn't have all those costs. Not to mention that reducing the cost to businesses will drive economic development in our state."

The bills face an uphill battle in the Republican-controlled legislature. Recently, Senate Republicans passed a bill that carves away at the state's Medicaid expansion by imposing work requirements on people receiving benefits. The original bill passed the Senate under the pretense that it would get more people working, but it would have kicked some people off their coverage and cost the state tens of millions of dollars to implement. The bill went on to pass the House with amendments and receive approval from Governor Rick Snyder. Up to 10 percent of Medicaid recipients are projected to lose their coverage under the new law.

Michigan is one of a number of states that have undercut affordable health care offerings following Congress' failure to repeal Obamacare last year. Meanwhile, other states are moving forward with plans for state-level universal coverage. New York is almost halfway there; a bill to create a single-payer system passed the state's General Assembly last month.

Polling shows most Americans believe it's the government's job to ensure all citizens have health coverage. According to polling by the Pew Research Center, 1 in 3 Americans specifically favor a single-payer approach. That's up from 5 percent in 2014.

Single-payer health care, often referred to on the federal level as Medicare for All, has made it onto the policy agendas of a growing number of Democrats since progressive Vermont Sen. Bernie Sanders ran for president in 2016. Those Democrats include gubernatorial candidates Abdul El-Sayed and Shri Thanedar.

You can read more about MiCare in the following explainer provided by Rep. Rabhi:

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