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Medicare is government-funded health insurance for older adults and people with certain disabilities. Proposals for “Medicare for All” would expand Medicare in two ways: It would insure every American and legal U.S. resident, and it would cover a more comprehensive set of health care services.
Various single-payer health care plans under the Medicare for All banner have been introduced in Congress since 2003, and the concept was championed by candidates Bernie Sanders and Elizabeth Warren during the 2020 Democratic presidential campaign.
Here are answers to some common questions about Medicare for All, as defined by the most recent congressional proposal: Sen. Sanders’ Medicare for All Act of 2022.
Who would Medicare for All cover?
Medicare for All would cover every American citizen and legal resident of the United States. That’s a dramatic expansion compared with the current set of government health insurance programs for civilians:
All together, the three programs cover more than 141 million people. The U.S. population is about 333 million people as of September 2022, so by covering the full population, Medicare for All would more than double that total.
What services would Medicare for All cover?
Medicare for All would cover a wide range of health care services, including some not currently covered by Medicare.
The current Medicare system separates coverage into parts:
Medicare for All would cover “comprehensive benefits,” which would encompass everything the current Medicare system covers under a single system. It would also include coverage for services not covered by Medicare, such as dental, hearing and vision care.
Would Medicare for All eliminate private insurance?
After a transition period, private insurance companies and employers wouldn’t be allowed to offer insurance policies that cover any of the same benefits covered by Medicare for All.
Private companies would still be allowed to sell or give their employees coverage for benefits that Medicare for All wouldn’t cover. Those benefits could include, for example, concierge care arrangements or services that aren’t medically necessary, such as certain cosmetic surgeries.
Would Medicare for All let me keep my doctor?
If your doctor already accepts Medicare — and 98% of health care providers do — they probably already meet the requirements of Medicare for All.
Medicare for All would require providers, hospitals and clinics to meet certain “national minimum standards” in areas such as quality of facilities, staffing ratios, personnel training and outcomes. Those standards aren’t new. They were first established as part of the original Medicare program, so most health care providers already meet them.
You would also be able to switch health care providers if you choose, because Medicare for All wouldn’t have in-network and out-of-network providers. You could receive services from any qualified provider.
Would Medicare for All have out-of-pocket costs?
Medicare for All would eliminate out-of-pocket costs like copays, coinsurance and deductibles for almost all services. There could be one exception: prescription drugs.
The Secretary of Health and Human Services would have the option to establish limited out-of-pocket costs for prescription drugs. The maximum annual out-of-pocket amount would be $200, and there would be no out-of-pocket costs for preventive drugs or for people with income below a certain level.
Pros and cons of Medicare for All
Here are some advantages and disadvantages of Medicare for All proposals:
Medicare for All pros:
Universal coverage: Every American and legal U.S. resident would have health coverage.
Lower out-of-pocket costs: Most covered services would have no copays, coinsurance or deductibles. Prescription drugs could have limited cost-sharing requirements.
No provider networks: Services would be available from any participating health care provider.
Medicare for All cons:
High health care utilization: More affordable health care could increase the demand for services, so there might be longer waits or more competition for appointments.
Tax changes: Medicare for All would be funded by new or increased taxes on income, payroll or wealth — the current proposal doesn’t specify which. New taxes could be a burden for some Americans, even if they’re at least partially offset by no longer needing to pay health insurance premiums.
Uncertain transition: Moving from the current system to Medicare for All would be a major change. The potential effects on the health care industry and the economy as a whole aren’t clear.