HR3069119th CongressWALLET

Medicare for All Act

Sponsored By: Representative Jayapal

Introduced

Summary

This bill would create a national health insurance program called "Medicare for All" to provide universal, comprehensive health coverage for every U.S. resident. It sets the benefit package, bans cost‑sharing for covered care, negotiates drug and device prices, and phases existing federal coverage into the new system during a multi‑year transition.

Show full summary
  • Families and children: Covers maternity care, pediatric services, mental health, prescription drugs, dental, vision, and more with no out‑of‑pocket costs for covered items. Children under 19 become eligible one year after enactment.
  • Older adults and people with disabilities: Establishes an entitlement to medically necessary long‑term services and supports in home and community settings, prioritizes independence and supports activities of daily living, and removes the 24‑month Medicare waiting period for people with disabilities.
  • Providers and the health system: Creates regional offices, pays institutional providers with negotiated quarterly global budgets and individual clinicians via a national fee schedule, restricts private contracting for covered services for two years, and gives the Secretary authority to negotiate prices and, if needed, license manufacture of drugs.

Bill Overview

Analyzed Economic Effects

14 provisions identified: 9 benefits, 0 costs, 5 mixed.

Long-term care and supports at home

If enacted, people with medical conditions that limit daily activities could get long‑term services and supports. The program would favor home and community services unless you choose otherwise. Services would be based on medical need and functional limits, and you could have options to self‑direct your care.

Nationwide coverage with no medical bills

If enacted, a national Medicare for All program would cover U.S. residents. It would pay for a wide range of medically necessary care, including hospital, primary care, drugs, mental health, dental, vision, and more. You would not owe deductibles, copays, or coinsurance for covered care, and providers could not balance bill you for covered services. Participating providers could not privately bill you for covered items.

National quality standards and equity data

If enacted, the government would set national clinical standards and performance measures and build a public database from provider reports. Methods that discriminate against people with disabilities in value or cost‑effectiveness ratings would be banned. The Office of Health Equity would publish detailed, disaggregated data and yearly reports, and could not use personal data for law enforcement or immigration. An Office of Primary Care would set national goals within one year and coordinate workforce and training. The program would study and improve disparities data collection on a set timeline.

Old plans phase out; no duplicates

If enacted, two years after enactment, people eligible under this bill would no longer get Medicare, Medicaid, or CHIP payments for services. FEHB would stop paying for eligible people, and TRICARE purchased care would generally stop (TRICARE Overseas may pay while abroad). VA and Indian Health Service care would not change. Private insurers and employers could not offer duplicate coverage, and COBRA would apply only to plans that do not duplicate program payments. Workers’ compensation insurers would have to reimburse the program for care they owe. Federal and state ACA Exchanges would end two years after enactment.

End federal value-based payment programs

If enacted, federal pay‑for‑performance and value‑based programs like MIPS, EHR incentives, APMs, and several ACA initiatives would end on the program’s effective date. Other laws tied to those programs would also stop.

National health budget and trust fund

If enacted, the Secretary would set a national health budget each year starting before benefits begin. The budget would include operating, capital, special projects, quality, workforce education, administration, a reserve, and prevention funds, with regional allotments and priority for underserved areas. At least 1% of the budget would help workers affected by insurance and administrative changes for up to five years. A Universal Medicare Trust Fund would receive specified revenue increases and transfers, plus an initial amount tied to prior federal health spending. Remaining Medicare trust fund balances could transfer after claims are paid.

One-year Medicare Buy-In plan

If enacted, for the year starting one year after enactment, a government Buy‑In plan would be sold on the Exchanges. It would cover most Medicare for All benefits at a 90% actuarial value. It would pay providers using the bill’s fee schedule and use negotiated drug prices. Premiums could vary by family type, age, and tobacco use. The Buy‑In would end when the main program starts.

Start dates and early enrollment protections

If enacted, most benefits would start two years after enactment. Some people would get coverage one year after enactment: those under 19 and those age 55 or older on that date. During the transition, plans generally could not cut off your coverage, and the Secretary would protect continuity of care, including for people with disabilities or complex needs. The 24‑month Medicare wait for people with disabilities would end for services after December 1 following enactment and before the two‑year start. Transition coverage would count as minimum essential coverage for tax rules.

Extra tax help for Buy-In premiums

If enacted, the Buy‑In would qualify for cost‑sharing help under the ACA. People who are lawfully present would be treated as having income at 100% of the poverty line for these rules, and special rules would apply in non‑expansion states. Tax credits for Buy‑In months would use a special table and would not cap help at 400% of the poverty line. These changes could lower your net premium and out‑of‑pocket costs if you enroll in the Buy‑In.

Rules for private contracts outside program

If enacted, starting two years after enactment, some providers could offer private contracts. You would have to sign a written contract before care, and contracts are not allowed in emergencies. Nonparticipating providers must file an affidavit within 10 days and agree not to bill the program for two years. Participating providers could only private contract for items the program does not cover. If a provider signs an affidavit but then bills the program, contracts could be voided and program payments suspended for two years.

New rules and penalties for providers

If enacted, providers would need to sign participation agreements, be licensed where the patient is located, treat patients without discrimination, and bill/report within tight timelines. Federal fraud and abuse rules would apply, and whistleblowers would be protected. Bonuses tied to utilization or conflicts of interest would be banned, and operating and capital funds could not be mixed. States could not block certified providers, and any state or local rule must preserve or expand access. Key terms like “medically necessary” and provider types would be defined.

Appeals help and doctor discretion

If enacted, the Secretary would set national rules for experimental coverage and create an appeals process similar to Medicare. A Beneficiary Ombudsman would take complaints and help with appeals. Your treating clinician could override guidelines when medically necessary and consistent with your wishes and state law.

Worker protections and licensing preserved

If enacted, your existing workplace rights under federal or state law and union contracts would stay in place. Employers could not punish you for reporting violations or refusing unlawful acts under this bill. The bill would not change state licensing and practice rules for health professionals.

Program funds not for registration enforcement

If enacted, money, staff, or equipment from this program could not be used to enforce any rule that makes people register based on religion, national origin, ethnicity, immigration status, or other protected traits.

Sponsors & CoSponsors

Sponsor

Jayapal

WA • D

Cosponsors

  • Dingell

    MI • D

    Sponsored 4/29/2025

  • Adams

    NC • D

    Sponsored 4/29/2025

  • Ansari

    AZ • D

    Sponsored 4/29/2025

  • Balint

    VT • D

    Sponsored 4/29/2025

  • Barragan

    CA • D

    Sponsored 4/29/2025

  • Bell

    MO • D

    Sponsored 4/29/2025

  • Beyer

    VA • D

    Sponsored 4/29/2025

  • Bonamici

    OR • D

    Sponsored 4/29/2025

  • Boyle (PA)

    PA • D

    Sponsored 4/29/2025

  • Brown

    OH • D

    Sponsored 4/29/2025

  • Carbajal

    CA • D

    Sponsored 4/29/2025

  • Carson

    IN • D

    Sponsored 4/29/2025

  • Carter (LA)

    LA • D

    Sponsored 4/29/2025

  • Casar

    TX • D

    Sponsored 4/29/2025

  • Cherfilus-McCormick

    FL • D

    Sponsored 4/29/2025

  • Chu

    CA • D

    Sponsored 4/29/2025

  • Clarke (NY)

    NY • D

    Sponsored 4/29/2025

  • Cleaver

    MO • D

    Sponsored 4/29/2025

  • Cohen

    TN • D

    Sponsored 4/29/2025

  • Crockett

    TX • D

    Sponsored 4/29/2025

  • Davis (IL)

    IL • D

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  • DeGette

    CO • D

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  • Deluzio

    PA • D

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  • DeSaulnier

    CA • D

    Sponsored 4/29/2025

  • Dexter

    OR • D

    Sponsored 4/29/2025

  • Doggett

    TX • D

    Sponsored 4/29/2025

  • Escobar

    TX • D

    Sponsored 4/29/2025

  • Espaillat

    NY • D

    Sponsored 4/29/2025

  • Foushee

    NC • D

    Sponsored 4/29/2025

  • Frankel, Lois

    FL • D

    Sponsored 4/29/2025

  • Friedman

    CA • D

    Sponsored 4/29/2025

  • Frost

    FL • D

    Sponsored 4/29/2025

  • Garamendi

    CA • D

    Sponsored 4/29/2025

  • Garcia (CA)

    CA • D

    Sponsored 4/29/2025

  • Garcia (IL)

    IL • D

    Sponsored 4/29/2025

  • Goldman (NY)

    NY • D

    Sponsored 4/29/2025

  • Gomez

    CA • D

    Sponsored 4/29/2025

  • Green, Al (TX)

    TX • D

    Sponsored 4/29/2025

  • Hayes

    CT • D

    Sponsored 4/29/2025

  • Hoyle (OR)

    OR • D

    Sponsored 4/29/2025

  • Huffman

    CA • D

    Sponsored 4/29/2025

  • Jackson (IL)

    IL • D

    Sponsored 4/29/2025

  • Jacobs

    CA • D

    Sponsored 4/29/2025

  • Johnson (GA)

    GA • D

    Sponsored 4/29/2025

  • Kamlager-Dove

    CA • D

    Sponsored 4/29/2025

  • Keating

    MA • D

    Sponsored 4/29/2025

  • Kelly (IL)

    IL • D

    Sponsored 4/29/2025

  • Kennedy (NY)

    NY • D

    Sponsored 4/29/2025

  • Khanna

    CA • D

    Sponsored 4/29/2025

  • Lee (PA)

    PA • D

    Sponsored 4/29/2025

  • Leger Fernandez

    NM • D

    Sponsored 4/29/2025

  • Levin

    CA • D

    Sponsored 4/29/2025

  • Lieu

    CA • D

    Sponsored 4/29/2025

  • Lofgren

    CA • D

    Sponsored 4/29/2025

  • McCollum

    MN • D

    Sponsored 4/29/2025

  • McGarvey

    KY • D

    Sponsored 4/29/2025

  • McGovern

    MA • D

    Sponsored 4/29/2025

  • McIver

    NJ • D

    Sponsored 4/29/2025

  • Meeks

    NY • D

    Sponsored 4/29/2025

  • Meng

    NY • D

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  • Mfume

    MD • D

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  • Min

    CA • D

    Sponsored 4/29/2025

  • Mullin

    CA • D

    Sponsored 4/29/2025

  • Nadler

    NY • D

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  • Neguse

    CO • D

    Sponsored 4/29/2025

  • Del. Norton, Eleanor Holmes [D-DC-At Large]

    DC • D

    Sponsored 4/29/2025

  • Ocasio-Cortez

    NY • D

    Sponsored 4/29/2025

  • Omar

    MN • D

    Sponsored 4/29/2025

  • Pallone

    NJ • D

    Sponsored 4/29/2025

  • Panetta

    CA • D

    Sponsored 4/29/2025

  • Pingree

    ME • D

    Sponsored 4/29/2025

  • Pocan

    WI • D

    Sponsored 4/29/2025

  • Pressley

    MA • D

    Sponsored 4/29/2025

  • Quigley

    IL • D

    Sponsored 4/29/2025

  • Ramirez

    IL • D

    Sponsored 4/29/2025

  • Randall

    WA • D

    Sponsored 4/29/2025

  • Raskin

    MD • D

    Sponsored 4/29/2025

  • Rivas

    CA • D

    Sponsored 4/29/2025

  • Salinas

    OR • D

    Sponsored 4/29/2025

  • Sanchez

    CA • D

    Sponsored 4/29/2025

  • Schakowsky

    IL • D

    Sponsored 4/29/2025

  • Scott (VA)

    VA • D

    Sponsored 4/29/2025

  • Sherman

    CA • D

    Sponsored 4/29/2025

  • Simon

    CA • D

    Sponsored 4/29/2025

  • Smith (WA)

    WA • D

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  • Stansbury

    NM • D

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  • Swalwell

    CA • D

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  • Takano

    CA • D

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  • Thanedar

    MI • D

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  • Thompson (MS)

    MS • D

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  • Thompson (CA)

    CA • D

    Sponsored 4/29/2025

  • Titus

    NV • D

    Sponsored 4/29/2025

  • Tlaib

    MI • D

    Sponsored 4/29/2025

  • Tokuda

    HI • D

    Sponsored 4/29/2025

  • Tonko

    NY • D

    Sponsored 4/29/2025

  • Trahan

    MA • D

    Sponsored 4/29/2025

  • Vargas

    CA • D

    Sponsored 4/29/2025

  • Velazquez

    NY • D

    Sponsored 4/29/2025

  • Waters

    CA • D

    Sponsored 4/29/2025

  • Watson Coleman

    NJ • D

    Sponsored 4/29/2025

  • Williams (GA)

    GA • D

    Sponsored 4/29/2025

  • Wilson (FL)

    FL • D

    Sponsored 4/29/2025

  • Harder (CA)

    CA • D

    Sponsored 4/29/2025

  • Ivey

    MD • D

    Sponsored 4/29/2025

  • Torres (NY)

    NY • D

    Sponsored 4/29/2025

  • Figures

    AL • D

    Sponsored 9/3/2025

  • Grijalva

    AZ • D

    Sponsored 11/20/2025

  • McClain Delaney

    MD • D

    Sponsored 12/2/2025

  • Johnson (TX)

    TX • D

    Sponsored 12/10/2025

  • Moskowitz

    FL • D

    Sponsored 12/10/2025

  • Elfreth

    MD • D

    Sponsored 12/18/2025

Roll Call Votes

No roll call votes available for this bill.

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