What Is Medicare for All?

The term “Medicare for All” is used by mostly progressive politicians to describe a single-payer, government-run health care program that covers all Americans. It doesn’t apply entirely to any one plan, but more to an overarching idea of expanding government health coverage to all Americans.

It often calls for a more robust version of Medicare — the government health insurance program for the elderly and disabled — to replace nearly all other public and private plans.

Medicare for All is essentially a single-payer system, in which the government pays for everyone’s health care instead of multiple groups — such as employers and private insurers.

Many Americans would be required to contribute taxes to finance the system. It’s unclear exactly what the cost to each American would be since the system is still largely theoretical.

The Congressional Budget Office analyzed some of the economic implications of Medicare for All and found that it could result in elimination of many health care costs to Americans and greatly expand coverage, but also noted that it would be a massive undertaking to successfully off.

One of Medicare for All’s biggest supporters is Vermont Senator and 2020 Democratic presidential candidate Bernie Sanders (I-Vt.). His Medicare for All proposal was a major part of his platform during the 2020 Democratic Primary.

According to the Kaiser Family Foundation, 10 different bills were introduced in the 116th Congress aimed at restructuring the country’s current health care system. Sanders — along with 14 co-sponsors in the Senate — introduced his own version in May 2022.

But despite the many versions of the movement that have been officially introduced as bills, it’s unlikely that Americans will see much, if any, movement on Medicare for All in 2023. It would mark an unprecedented and dramatic overhaul to the current health system that could potentially require years of planning.

It also would need significant support throughout the U.S. government, and currently is still only largely supported among progressive Democrats.

Meanwhile, other Democrats have proposed more incremental approaches that offer a public plan option that would keep current sources of coverage in place. There have also been calls to refine the existing system by making updates to Obamacare or lowering the Medicare eligibility age.

The term Medicare for All simply sounds more appealing to many Americans than the term single-payer health care.

According to a 2019 Kaiser Family Foundation poll, 49% of people approved of single-payer health care, while 63% of people approved of Medicare for All.

But the current Medicare system is very different from what Sanders and other lawmakers have proposed.

The biggest difference is eligibility. Currently, Medicare is only available to people ages 65 and older, some people with long-term disabilities and those with End-Stage Renal Disease or Lou Gehrig’s disease. Medicare for All would create universal coverage for everyone.

Medicare for All can be a divisive subject.

Supporters claim it’s the best way to cover every American and hold down escalating health care costs.

Critics argue that the program would be expensive and question how the government can effectively manage such a massive system.

Increased cost is one of the most common arguments against Medicare for All.

A 2018 study by the RAND Corporation estimated that federal spending on health care would have increased from $1.09 trillion in 2019 to $3.5 trillion if a single-payer plan passed (although the decrease in spending by state and local government, private businesses and households would generally have offset that).

The price tag of Medicare for All has been widely debated.

Sanders himself has said economists estimate Medicare for All costing between $40 trillion and $50 trillion over 10 years.

Research by Urban Institute — a nonpartisan Washington, D.C. think tank — estimates the program costing between $32 trillion and $34 trillion over 10 years.

In January 2020, a team of researchers from the University of California conducted an economic analysis of 22 different single-payer plans proposed over the past 30 years.

Their research, published in a paper in PLOS Medicine, found that 91% of the analyses predicted net health care savings over several years.

But as researchers summarized: “Actual costs will depend on plan features and implementation.”

As a 2019 article from The New York Times pointed out: “The many questions and nuances are all reminders that single-payer is more complicated than the campaign talking points on either side might suggest.”

Medicare for All became one of the major topics of the 2020 Democratic Primary and Presidential Election, due in part to Sanders’ support of the idea.

Support was mixed throughout the party, however, with the Democratic candidates offering a wide range of ideas on how to address the issues of the U.S. health care system. According to the Washington Post, both Sanders and Warren fully endorsed Medicare for All, while candidates like Kamala Harris and Corey Booker supported a version of it that still allowed a role for private health care.

More moderate candidates like Joe Biden and Pete Buttigieg were opposed to Medicare for All, preferring to find some other option or plan like possibly updating and reforming Obamacare.

Since Biden went on to win the nomination — and eventually the presidency — Medicare for All was not adopted as part of the Democrats’ agenda.

There are still active Medicare for All bills, including a renewed push by House Democrats in early 2021, but the actual passing of any legislation doesn’t appear to be imminent. Medicare for All’s status moving forward — and whether it will ever gather the support needed in its current form to become a law — is unclear.

Outside of Medicare for All, there have been several other attempts in recent years to make changes or updates to the U.S. health system. Many of these ideas have involved altering the rules of who can enroll in Medicare or Medicaid.

One example is the Medicare at 50 Act. According to Yahoo, this bill was proposed by 21 Democratic senators in 2021 and would lower the age eligibility requirement to enroll in Medicare by 15 years.

The change could open Medicare coverage up to millions more Americans each year, giving them access to affordable care that they may not be able to get otherwise.

However, there are concerns about the additional strain this would add to the already tenuous Medicare system. It also could have major workforce implications since it may encourage some Americans to retire much earlier.