Here's a cut and paste:

This is an informative post for anybody who has questions about the 4-year transition, who think that the transition period isn't clearly defined, who may not have clearly or fully read the transition part of bill.

There are two forms of transition embedded into the Medicare for All Act of 2019 introduced by Bernie Sanders in April of this year:

1. Medicare Buy-In Program
This is the one usually discussed when we talk about Bernie's bill. Benefits under Medicare will be increased to match those offered under Medicare for All. This improved Medicare will be offered as a buy-in plan by lowering the age of eligibility for Medicare as follows:

Lower to 55 and for people under 19 in year 1

Lower to 45 in year 2

Lower to 35 in year 3

Cover everyone in year 4

This is clear and concise. The annual premiums for this will be decided based on the annual per capita costs of providing the services.

2. Medicare Public Option Plan
This is something I haven't seen anybody mention at all. Bernie’s bill also offers a complex (as is the case with ACA and anything related to it) public health plan (called Medicare Transition plan) as an option through the Exchanges (ACA markets, in plain words). In other words, improved Medicare will be offered as a public option to everybody through the Exchanges, as the public option enthusiasts and Pete want but with a clear 4-year end to it.

Absolutely anybody can enroll in this public option, including employers who wish to make it available to their employees.

There is plenty of text in regards to this (covering prescription drugs, premiums and assistance, tax credits, etc.) that is very specific. Premiums would be decided based on dependents, age, tobacco use, etc., but not location.

Based on the federal poverty line (about $12.5k for an individual and $25.7k for a family of four), the percent of income charged as premium shall be determined as follows:

Up to 100% of the federal poverty line: 2% of your income

100-138%: 2.04%

138-150%: 3.06-4.08%

150% and above: 4.08-5%

This second part (public option) of the transition which is essentially what many people say that they prefer is extremely important in convincing people to vote for Bernie and support Medicare for All. It's still a 4-year transition period.

And lastly, the premiums/taxes under these transition plans would be higher than what they would be under Medicare for All since Medicare for All will have a much larger risk pool and can therefore bring the prices further down.

I hope this information was helpful to many of you. DO NOT FORGET THE PUBLIC OPTION PART OF THE TRANSITION PLAN UNDER BERNIE’S BILL.

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And here is a great argument for why a permanent public option is a bad idea.

The best argument for Medicare For All? You get more for less. It's your health, vision, and dental for less money than we currently spend on health insurance alone. That is truly the "Art of the Deal"! How much more? The Mercatus Center, which is a libertarian think tank at George Mason University, projects Medicare for All will cost $33 trillion over 10 years. That's $3.3 trillion a year. We already spend more than that. At current spending, we'd spend at least $34 trillion with our current system and likely much more than that. Why? Because healthcare is a giant price fixing scheme. Medical device manufacturers and pharmaceutical companies gouge hospitals. Hospitals then gouge patients. Insurance companies then raise premiums on patients.

You'd think insurance companies have an incentive to prevent this. However, they don't. Why? Shareholder capitalism. Shareholders always want an increasing return quarter over quarter. That puts pressure on market (i.e. publicly traded) traded insurance companies to deliver.

Now, consider how health insurance companies make money. They essentially have four ways of doing this.

Cut costs, i.e. deny more claims, taking price gougers to the mat, get more people on high and higher deductible plans, become more efficient, etc.
Invest better,, i.e. own a better asset portfolio that yields a greater return on investment
Make more sales, i.e. sell more policies and get more people covered
Raise prices, i.e. increase premiums
Cutting costs is hard. Investing can be hard, too. Making more sales is also hard and we see this in a relatively constant rate of people who are uninsured (Its been about 30 million, or 10%, since the implementation of the ACA). But you know what isn't hard? Charging higher premiums. Think about how this works. As the insurance company's costs rise, so do an insurance company's profits! Imagine profits are fixed at roughly 5%. At $1,000 of revenue, your profit is $50. At $10,000, now you're making $500. At $100,000, now you're making $5,000. In other words, 5% of a big number is still a big number. So long as the insurance companies have a similar number of people insured year over year, this can only work in their favor.

Medicare for All will put a stop to this crap. How? Collective bargaining power. By banding everyone together under one system - WITHOUT PRIVATE INSURANCE AS AN ALTERNATIVE - everyone becomes invested in making our public insurance system the best it can possibly be. This is the dynamic that will keep the middle classes invested politically, too. They're the group most susceptible to the siren song of privatization...because everyone finds the concept of more for less alluring even if it's a lie. Hence, we have to keep them in and private insurance out. That's solidarity.

What does this mean for a public option? It means it's a bad idea. Medicare for All Who Want It will be a boondoggle. Why? Because underwriting. Underwriting, for those who don't know, is risk assessment. In the past, health insurance underwrote customers by having them document their health history and charging rates (or not offering coverage) accordingly (and by excluding pre-existing conditions, too). The ACA got rid of that in favor of community rating. In other words, everyone in an area is underwritten as a whole. How do you underwrite everyone as a whole in order to fuck poor people, minorities, and unhealthy people? You don't sell coverage in those areas. You only sell it in areas where people are relatively healthy. Hence, you force the unhealthy onto a public option.

Where does this leave a public option? As a cost sink. By putting all the bad risks (i.e. unhealthy people - and we use minority status, income, and other factors to make a guess at which areas have the most unhealthy people), on a public option - you drive up the costs of the public option while minimizing your own. Hence, you undermine the system and doom it to failure, repeal, and privatization. And then the whole cycle begins again.

This, brothers and sisters, is what we call anti-selection. Remember that word. That is what Medicare for All Who Want It encourages.