Full breakdown available
This pages provides a high-level overview of this bill. For full list of provisions, line-item appropriations, and specific funding allocations, please view our detailed breakdown.
Summary
Creates a national health insurance program to give every U.S. resident full health care coverage, replacing most private insurance.
What problem does this solve?
Many people in the U.S. do not have health insurance or have plans that do not cover all their needs, leading to high medical bills. This bill creates a single government health program to cover everyone and remove costs like deductibles and copayments.
What does this bill do?
Establishes a universal health insurance program
Creates the 'Medicare for All Program' to provide national health insurance for every resident of the United States.
Prohibits private insurance that duplicates coverage
Makes it illegal for private insurance companies or employers to sell or provide health plans that cover the same benefits as the Medicare for All program.
Eliminates most out-of-pocket costs
Bans deductibles, copayments, and coinsurance for all covered medical services. Cost-sharing may only apply to some prescription drugs, capped at $200 per year.
Provides comprehensive medical benefits
Covers a wide range of services, including hospital care, doctor visits, prescription drugs, dental, vision, mental health, and long-term care.
Reference
Text:
Section:
Sec. 611, 612
Header:
Payments to institutional providers based on global budgets
Changes how hospitals and doctors are paid
Moves hospitals and other institutions to a 'global budget' system, where they receive a lump sum to cover all operating costs. Individual doctors would be paid based on a fee schedule.
Reference
Text:
Section:
Sec. 614
Header:
Payments for prescription drugs and approved devices and equipment
Requires government negotiation of drug prices
Directs the Secretary of Health and Human Services to negotiate prices for prescription drugs, medical devices, and equipment each year.
Creates a four-year transition plan
Phases in the program over four years, starting by lowering the Medicare eligibility age and offering a new public health plan before the full program begins.
Establishes a Medicare for All Trust Fund
Creates a new trust fund to pay for the program, funded by redirecting money from existing federal health programs like Medicare and Medicaid, as well as new taxes.
Provides assistance for displaced workers
Allocates at least 1% of the national health budget for up to five years to help workers in the health insurance industry who lose their jobs due to the new system.
Strengthens non-discrimination protections
Prohibits discrimination based on race, gender identity, sexual orientation, disability, and other factors, and allows people to sue for damages if they are discriminated against.
Who does this affect?
- All U.S. residents
- Health insurance industry employees
- Healthcare providers
What is the real world impact?
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Ensures universal healthcare coverage
Provides every resident of the United States with comprehensive health insurance, regardless of their income, employment, or health status. This aims to solve the problem of millions of people being uninsured or underinsured.
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Reduces administrative costs in healthcare
Creates a single government-run program to handle payments. This could lower the total cost of healthcare by getting rid of the complex and expensive administrative work done by hundreds of different private insurance companies.
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Increases government control over healthcare
Gives the federal government the power to set health budgets, negotiate drug prices, and decide which services are covered. Some may oppose this as giving the government too much influence over personal medical decisions and the healthcare market.
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Eliminates the private health insurance industry
Makes it illegal for private companies to sell insurance that covers the same benefits as the new government program. This would effectively end the private health insurance industry as it currently exists, leading to major job losses and economic shifts.
When does this start?
The program is phased in over four years, with different parts taking effect each year.
Reference
Text:
Section:
Sec. 1003, 1011, 1012
Header:
Expanding Medicare to cover dental and vision services
Initial Medicare improvements and public option
On January 1 of the first year after enactment, Medicare is expanded to cover dental and vision, the Medicare eligibility age is lowered to 55, and a new public health plan becomes available.
Coverage for children
On January 1 of the first year after enactment, all individuals under the age of 19 become eligible for benefits under the Medicare for All program.
Further lowering of Medicare age
The Medicare eligibility age is lowered to 45 on January 1 of the second year, and to 35 on January 1 of the third year after enactment.
Full program implementation
On January 1 of the fourth year after enactment, the full Medicare for All program becomes available to all U.S. residents, and the ban on duplicate private insurance takes effect.