Harris's Medicare for All plan would have some automatic enrollment but some private insurance options, as well.
According to her website, "First, when we pass my plan, all Americans will immediately have the ability to buy into Medicare. This is similar to the immediate, introductory buy-in provided in Senator Sanders’ Medicare for All bill. Right away, it will lower costs and give us a baseline plan as we transition to Medicare for All.
"Second, we will set up an expanded Medicare system, with a 10-year phase-in period. During this transition, we will automatically enroll newborns and the uninsured into this new and improved Medicare system, give all doctors time to get into the system, and provide a commonsense path for employers, employees, the underinsured, and others on federally-designated programs, such as Medicaid or the Affordable Care Act exchanges, to transition. This will expand the number of insured Americans and create a new viable public system that guarantees universal coverage at a lower cost. Expanding the transition window will also lower the overall cost of the program.
"Third, in setting up this plan, we will allow private insurers to offer Medicare plans as a part of this system that adhere to strict Medicare requirements on costs and benefits. This would function similar to how private Medicare plans work today, which cover about a third of Medicare seniors, and operate within the Medicare system. Medicare will set the rules of the road for these plans, including price and quality, and private insurance companies will play by those rules, not the other way around. This preserves the options that seniors have today and expands options to all Americans, while also telling insurance companies they don’t run the show.
"Unlike the current system, private plans in the new Medicare system will be held to stricter consumer protection standards than they are today, such as getting reimbursed less than what the Medicare plan will cost to operate, to ensure that they are delivering meaningful value and unable to profit off of gaming consumers or the government. People will also be able to purchase supplemental insurance covering services not included in Medicare, such as medical insurance for traveling abroad, or cosmetic surgery.
"Essentially, we would allow private insurance to offer a plan in the Medicare system, but they will be subject to strict requirements to ensure it lowers costs and expands services. If they want to play by our rules, they can be in the system. If not, they have to get out."