What Is Medicare for All and How Does It Work?

Medicare for All is a system that would expand the current availability of taxpayer-supported health care in the United States. It would feature a single-payer, government-run program that would replace most existing public or private plans.

Medicare for All would not eliminate the private health insurance industry. It would change what coverage people could elect beyond what basic care provides under this universal system. The result would be something similar to the structure of Canada’s system.

During the 2020 election cycle, a majority of Democratic presidential candidates support some version of this idea, so it is essential to know how it works. If you want more coverage of the upcoming Presidential election, take a look at the 100 news sites you should add to your news feed.

Medicare for All Would Require a 4-Year Transition

The primary driver of the Medicare for All idea comes from a bill sponsored by Senator Bernie Sanders. Under the structure of this single-payer plan, essential treatments would receive coverage without any deductibles or premiums.

It would also expand the number of benefit categories in the current Medicare system so that vision and dental coverage would become available.

Transitioning from the current system in the United States to Medicare for All would take about four years to complete. Once the legislation is active, then private insurers could not sell a plan that offered similar coverage. 

They would get the opportunity to provide a supplemental plan that covers items unavailable in this system, such as a voluntary surgery.

Federal health programs that currently exist, such as the Veterans Health Administration, would continue uninterrupted in their services.

How Much Would Medicare for All Cost?

The estimated national spending on health care in the United States is approximately $4 billion each year. About $1.5 trillion of that comes from the current Medicare and Medicaid programs that people use.


Then another $1.5 trillion comes from private health insurance and out-of-pocket costs.

The Sanders’ proposal is one of the most expensive ideas being debated today. It would eliminate all private health insurance spending from health care, causing Medicare and Medicaid costs to rise to over $3 trillion annually.

Several different versions of this idea are up for debate, with some House bills having over 100 co-sponsors. Most Democrats want something a little more modest than what is outlined above, with the goal being to expand Medicare and Medicaid access without ending the private insurance system as it stands today.

How is Medicare for All Different from Obamacare?

Under the Affordable Care Act, the goal was to provide opportunities for people to afford health insurance when they were unable to obtain it from an existing program or their employer. The ACA offers subsidies to help purchase private plans from a government exchange while also expanding Medicaid.

This approach helped to cover millions of people, but there are still over 27 million individuals without health care insurance.

Medicare for All would solve the problem by ensuring that everyone could access a doctor when needed without worrying about the price.

Payroll taxes would likely rise in any scenario, but the monthly cost of insurance premiums and doctor visits could go down enough to create a net gain for families.

This structure would put the United States more in line with the rest of the world’s approach to providing health care. 
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