Summary

Creates a national single‑payer health system that replaces most existing federal health coverage with a universal “Medicare for All” program that guarantees medically necessary care to U.S. residents with no cost‑sharing, balance billing, or routine prior authorization. It sets benefit rules, provider participation requirements, a national budgeting and payment system (including global budgets and a national fee schedule), a new Universal Medicare Trust Fund to pay for the system, and a two‑year transition with a one‑year buy‑in option offered through the ACA Exchanges. Requires the Department of Health and Human Services to run the program, issue enrollment rules and universal ID cards, create regional offices and ombudsman services, negotiate drug prices, collect equity and quality data, and phase out or convert many existing federal health payment programs; it also adds ERISA conforming rules to prevent duplicate payments from employer plans during implementation.

Key Points

• Creates a national single‑payer "Medicare for All" program that guarantees comprehensive medically necessary care with no cost‑sharing or balance billing.
• Establishes a Universal Medicare Trust Fund to finance the program and requires annual national budgeting and new payment models (global budgets and a national fee schedule).
• Prohibits routine prior authorization, bans profit/marketing payments from program funds, and mandates annual drug price negotiations with backup licensing authority.
• Requires provider participation agreements, federal quality and reporting standards, anti‑retaliation protections, and limits on private cash‑only contracting.
• Directs HHS to run the program with regional offices, an ombudsman, regular audits, equity data collection, and extensive reporting requirements.
• Phases out or converts many existing federal health payment programs for covered individuals and adds ERISA rules to prevent duplicate payments from employer plans.
• Creates a two‑year transition with a one‑year buy‑in option via the ACA Exchanges covering the same benefits at ~90% actuarial value.
• Includes detailed rules for long‑term services and supports, data collection on disparities, and protections for veterans, Native Americans, and TRICARE beneficiaries.
• Imposes major administrative, fiscal, and market changes affecting insurers, providers, pharmaceutical manufacturers, states, and employers.
• Defines key terms and limits state actions that would undermine access while preserving state licensing and workplace protections.

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