Massachusetts Candidate For Governor Supports Medicare-For-All, Including Illegal Immigrants

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If you like your health care plan, you won’t be able to keep it if Massachusetts gubernatorial candidate Sonia Chang-Diaz gets what she wants.

That’s because Chang-Diaz, a Democratic state senator from Jamaica Plain, supports enacting Medicare-for-all at the state level in the Commonwealth of Massachusetts. And the version of Medicare-for-all that Chang-Diaz supports would cover illegal immigrants.

Chang-Diaz is a sponsor of Massachusetts Senate Bill 766, titled “An Act Establishing Medicare For All In Massachusetts.”

The proposal would cover in-staters and out-of-staters who work in Massachusetts and otherwise qualify for it. The bill says that it would cover “all Massachusetts residents, regardless of citizenship status, including incarcerated persons.” It also says that it would cover non-residents who “work 20 hours or more per week in Massachusetts; pay all applicable Massachusetts personal income and payroll taxes; and pay any additional premiums established by the Trust to cover non-residents.”

Chang-Diaz’s campaign web site reiterates her support for Medicare-for-all, although it doesn’t address the part about illegal immigrants.

“A single-payer or ‘Medicare for All’ system is the surest and most efficient way for us to achieve the goals of universal care at a sustainable cost,” Chang-Diaz’s web site says. “Many countries around the world have better health outcomes for their people, at a fraction of the cost — achieved through a simplified single-payer system. That is why I will continue to support measures to transition our state to ‘Medicare for All.’ In the meantime, I will continue the tradition set by our 2006 health reform law by asking all parties to share in the responsibility for keeping the system solvent:  employers, insurers, the public sector, health care providers, and individuals.”

The plan that Chang-Diaz supports would pay for Medicare-for-all with a payroll tax.

The proposed funding mechanism is a 7.5 percent employer-side payroll tax and a 2.5 percent employee-side payroll tax. The first $20,000 of an employee’s income would be exempt on both sides. However, the proposal includes a surcharge on larger companies. Businesses that employ more than 100 people would have to pay an additional 0.5 percent payroll tax on the employer side.

Self-employed individuals would pay a 10 percent payroll tax — with the first $20,000 of their income exempt. Additionally, the bill would create a 10 percent tax on “unearned income” above $20,000 annually. Examples of unearned income include inheritance and passive investments that earn dividends.

The health care proposal would come in addition to existing taxes on various sorts of income that support state and federal government services such as Social Security, unemployment benefits, Supplemental Security Income, and Social Security Disability Insurance taxable.

The plan would cover more health care needs than the current version of Medicare does and would have no copayments, deductibles, or other forms of patient cost-sharing, according to the bill.

The bill doesn’t say all the types of health care services the plan would cover. Instead, it says, the plan would cover everything deemed medically necessary or appropriate by the Trust.

However, the bill includes a long list of some of the covered benefits:


(1) prevention, diagnosis and treatment of illness and injury, including laboratory, diagnostic imaging, inpatient, ambulatory and emergency medical care, blood and blood products, dialysis, mental health services, palliative care, dental care, acupuncture, physical therapy, chiropractic and podiatric services;

(2) promotion and maintenance of individual health through appropriate screening, counseling and health education;

(3) the rehabilitation of sick and disabled persons, including physical, psychological, and other specialized therapies;

(4) mental health services, including supportive residences, occupational therapy, and ongoing outpatient services;

(5) behavioral health services, including supportive residences, occupational therapy, and ongoing outpatient services;

(6) substance misuse services, including supportive residences and ongoing outpatient service;

(7) prenatal, perinatal and maternity care, family planning, fertility and reproductive health care, including abortion;

(8) long-term services and supports including home health care and personal support care;

(9) long term care in institutional and community-based settings;

(10) hospice care;

(11) language interpretation and such other medical or remedial services as the Trust shall determine;

(12) emergency and other medically necessary transportation;

(13) the full scale of dental services, other than cosmetic dentistry;

(14) basic vision care and correction, including glasses, other than laser vision correction for cosmetic purposes;

(15) hearing evaluation and treatment including hearing aids;

(16) prescription drugs;

(17) durable and non-durable medical equipment, supplies, and appliances, including complex rehabilitation technology products and services as medically necessary, individually-configured manual and power wheelchair systems, adaptive seating systems, alternative positioning systems, and other mobility devices that require evaluation, fitting, configuration, adjustment or programming; and

(18) all new emerging technologies irrespective of where the parent company is located, such as telemedicine and telehealth practitioners.


Medicare-for-all is an issue that divides the Democratic Party. President Joe Biden doesn’t support Medicare-for-all and railed against the proposal during the 2020 Democratic presidential primary. 

Biden spoke about his opposition to Medicare-for-all at a February 2020 Nashua, New Hampshire rally attended by a NewBostonPost reporter.

“It costs a lot of money, but we can do it without raising taxes on the middle class,” Biden said in his speech Tuesday, February 4, 2020. “It’s not $30 trillion like Medicare-for-All. Thirty to 40 trillion. I can get my plan passed through the United States Congress. I can get it passed right away. Senator Sanders, God love him, and the others have attacked my health care plan. They say, ‘it’s too small.’ Well, first of all, they’re dead wrong about the amount of coverage. [Obamacare] was a historic achievement this party should be proud to defend. But look, Bernie has talked about the single-payer health care system for 30 years now. He hasn’t moved it an inch.”

No state has enacted single-payer health care at the state level. Vermont attempted to implement single-payer health care several years ago but was unsuccessful, as Biden pointed out during his speech in Nashua.

That plan, known as Green Mountain Care, would have required an 11.5 percent payroll tax on businesses and an increase in the state income tax to as high as 9.5 percent. State officials abandoned the idea in 2014.

The Democratic governor at the time, Peter Shumlin, said in September 2017 that he regretted his efforts to bring it about.

“The lesson was:  I was wrong,” Shumlin said, according to The Burlington Free Press“I don’t think small states can go it alone, at least little states like Vermont, with an unstable federal partnership.”

A spokesman for Chang-Diaz could not be reached for comment over the weekend or on Monday this week.


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