Sen. Richard Blumenthal LAW ’73, D-Conn., and Sen. Chris Murphy, D-Conn., are divided over a proposal to expand Medicare into a universal health care program.

Blumenthal is among 16 senators, including Sen. Bernie Sanders, I-Vt., who support the bill, which was announced on Sept. 13. Under the proposal, Medicare would expand to include more Americans and would eventually function as a single-payer system run entirely by the government. Private insurance, deductibles, co-pays and premiums would be stamped out.

“Access to affordable health care should be a clear right, not an exorbitant luxury,” Blumenthal said in a Sept. 12 statement. “That’s why I’m proud to join my colleagues in the Senate and Americans around the country supporting a system to give every family access to the security and stability of Medicare.”

A day later, Murphy told MSNBC that he shares Blumenthal’s goal of a single-payer health care system but does not support a large-scale expansion of Medicare. He said he wants Americans to have a choice between their own private plans and a public option.

“I’ve introduced a different concept to allow every American to buy into Medicare and essentially allow consumers to decide whether they want private insurance or Medicare,” he said. “My belief is that given that choice, consumers would choose Medicare, and it would allow for almost a more natural transition into a single-payer system.”

Fiona Scott Morton ’89, a health economist at the School of Management, said that although Blumenthal’s bill could lead to less innovation in the long run, it may also make health care less expensive for Americans because the higher taxes required to fund it would still be lower than the premiums people currently pay for private insurance.

Still, she is concerned that such a major overhaul of the Medicare system in such short order could have economic repercussions.

According to Jacob Wallace, an assistant professor at the School of Public Health, those currently enrolled in Medicare can choose between Medicare Advantage, in which the government pays insurance companies to take care of a person, and Medicare Fee-for-Service, in which the person’s claims are paid for directly by the government.

Wallace said the plan supported by Sanders and Blumenthal would place Americans into a single plan similar to Medicare Fee-for-Service but would eliminate the choice of a private Medicare Advantage plan.

“The Medicare system is well-established, and every provider uses it and has many Medicare customers,” Morton said. “So the infrastructure is in place, and adding more people to that infrastructure is not as difficult as, for example, starting up a state exchange.”

Murphy’s approach may not lead to a single-payer health care system as quickly as Blumenthal’s. But Wallace said it is unique in that it uses an existing mechanism, Medicare, to allow people to move between public and private plans.

Still, Morton said many Americans are satisfied with their current health plans and may not want to switch to Medicare. She added that the program might expand gradually if people were given the option to buy into Medicare and “slowly migrated into the exchange.”

Jack Jensen | jack.jensen@yale.edu