Medicare for All Act
Sponsored By: Senator Bernie Sanders
Introduced
Summary
Creates a national, no-cost-at-point-of-service health insurance program that would cover all U.S. residents and automatically enroll people at birth or when they establish residency. It would guarantee a broad benefits package including hospital care, prescription drugs, mental health and substance use treatment, dental and vision, home- and community-based long-term care, gender-affirming care, and reproductive services while generally prohibiting patient cost-sharing except limited prescription drug copays.
Show full summary
- Families, children, and low-income households would get automatic enrollment and a comprehensive benefits package with no patient cost-sharing for covered services. Prescription drug cost-sharing could be up to $200 per person per year and is waived for households at or below 250% of the federal poverty level.
- Providers and hospitals would face a new dual payment system that shifts many institutional providers to quarterly global budget payments while keeping a fee-for-service path for others. Global budgets are negotiated annually and can be adjusted for emergencies or major cost shifts.
- States and Medicaid beneficiaries would see Medicaid rules adjusted so states must preserve institutional long-term care and meet a state-specific expenditure floor based on 2024 spending. States may add benefits at their own expense but may not tighten eligibility below January 1, 2025.
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Bill Overview
Analyzed Economic Effects
10 provisions identified: 6 benefits, 0 costs, 4 mixed.
Automatic enrollment and phased start
If enacted, newborns and new residents would be automatically enrolled and issued a Medicare for All ID card (without a Social Security number). Children under 19 would get benefits earlier; most adults would get benefits starting January 1 of the fourth year after enactment. The Secretary must protect people from care disruptions and consult disability and patient groups during transition.
Much broader coverage and lower patient costs
If enacted, people enrolled would get a wide set of covered services, including hospital care, drugs, mental health, pregnancy care, dental, vision, hearing, and long-term supports. Most cost sharing would be banned and Part A and Part B deductibles set to $0. An annual out-of-pocket limit of $1,500 would apply to Part A and B cost-sharing, and drug rules would cap some prescription out-of-pocket at a low annual amount with special transition rules.
Special tax credits for Transition plan
If enacted, coverage under the Medicare Transition Plan would count as a qualified plan for premium tax credits. The bill inserts a special applicable-percentage table to compute premium help for Transition enrollees, which can lower premiums for eligible households during the transition.
New oversight, reporting, and equity offices
If enacted, the Secretary would set uniform reporting rules, build a national database on costs, quality, and equity, and report to Congress annually. The bill would create Regional Medicare for All Offices to assess local needs and an Office of Health Equity to collect detailed demographic data and protect privacy. These steps aim to improve transparency and help target health disparities.
End old plans and ban duplicate coverage
If enacted, when Medicare for All benefits start the bill would end Federal and State ACA Exchanges, repeal COBRA continuation coverage, and stop Medicare, Medicaid, and CHIP payments for services furnished after the start date (with limited transition exceptions). It would also bar private insurance and employer plans from duplicating Program benefits, and require workers' comp carriers to reimburse the Program for covered services.
Create Medicare for All Program
If enacted, the federal government would create a Medicare for All Program run by the Secretary. The Secretary would write rules for who is eligible, what is covered, and how providers are paid. The bill would require an annual National Health Budget and create a Medicare for All Trust Fund with annual appropriations tied to specified tax changes and prior federal health program funding.
New provider payment and rules
If enacted, the bill would shift hospital and institutional payments to annual negotiated global budgets paid quarterly and set a national fee schedule for non-institutional providers. Providers would face national participation rules, reporting deadlines, and restrictions on how Program payments are used. The Secretary must also publish standardized physician payment review methods and permit audits.
Patient protections, privacy, and benefits safety
If enacted, the bill would ban discrimination in Program benefits and create an administrative complaint process and private right of action. It would protect workers who report violations, create a Beneficiary Ombudsman to help with appeals, raise SSI resource limits starting January 1, 2025, and bar predeath Medicaid liens and recovery for correctly paid assistance. Medigap issuers could not deny coverage or price based on health status.
State rules for long-term care protections
If enacted, States would have to continue providing institutional long-term care services once Medicare for All benefits begin and could not adopt stricter income, resource, or eligibility standards than on January 1, 2025. The Secretary would set state-specific spending floors and States may add supplemental standards only if they do not reduce eligibility or access.
Transition plan and temporary buy-ins
If enacted, a Medicare Transition public plan would be offered on the Exchanges until Medicare for All starts. The plan must cover required benefits and be about 90% actuarial value. The bill would also allow staged buy-ins for adults age 55, 45, then 35 in successive years, with monthly premiums set each year by the Secretary.
Sponsors & CoSponsors
Sponsor
Bernie Sanders
VT • I
Cosponsors
Tammy Baldwin
WI • D
Sponsored 4/29/2025
Richard Blumenthal
CT • D
Sponsored 4/29/2025
Cory Booker
NJ • D
Sponsored 4/29/2025
Kirsten Gillibrand
NY • D
Sponsored 4/29/2025
Martin Heinrich
NM • D
Sponsored 4/29/2025
Mazie Hirono
HI • D
Sponsored 4/29/2025
Sen. Luján, Ben Ray [D-NM]
NM • D
Sponsored 4/29/2025
Edward Markey
MA • D
Sponsored 4/29/2025
Jeff Merkley
OR • D
Sponsored 4/29/2025
Alex Padilla
CA • D
Sponsored 4/29/2025
Brian Schatz
HI • D
Sponsored 4/29/2025
Adam Schiff
CA • D
Sponsored 4/29/2025
Elizabeth Warren
MA • D
Sponsored 4/29/2025
Peter Welch
VT • D
Sponsored 4/29/2025
Sheldon Whitehouse
RI • D
Sponsored 4/29/2025
Roll Call Votes
No roll call votes available for this bill.
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