Sponsors (117)
Official title: To establish an improved Medicare-for-All national health insurance program.
Introduced April 29, 2025 by Pramila Jayapal · Last progress April 29, 2025
The bill promises guaranteed, comprehensive, no‑cost‑sharing health care and stronger equity, transparency, and predictable provider funding, but does so by massively expanding federal spending and restructuring or ending many existing programs—creating major fiscal, provider, administrative, legal, and transition risks that could strain access, choice, and privacy.
All U.S. residents would gain single‑payer, comprehensive health coverage with no cost‑sharing for hospitalization, primary care, mental health, reproductive and gender‑affirming care, long‑term services and supports (LTSS), and transportation, plus simplified enrollment and a standardized ID.
Enrollees receive strong financial protections: bans on balance billing, elimination of patient cost‑sharing, and premium tax credits/subsidies (including high‑value Buy‑In plans) that substantially reduce out‑of‑pocket costs.
Vulnerable populations get immediate and preserved access: people with disabilities get Medicare without the 24‑month wait, transition coverage for adults 55+ and youth begins quickly, and school‑based, VA, IHS, and uniformed‑service care continuity is maintained.
Taxpayers and federal budgets face very large new costs and sustained fiscal demands to finance comprehensive, no‑cost‑sharing coverage, major trust fund transfers, and initial appropriations—likely requiring higher taxes or reallocation of federal spending.
The bill would disrupt existing programs and benefits by sunsetting or terminating current Medicare/Medicaid/CHIP payment paths, ending FEHB purchased‑care and parts of TRICARE, and closing ACA exchanges, creating transition risks, administrative gaps, and state revenue losses.
Providers—especially rural, safety‑net, and high‑cost area facilities—could face financial strain or opt out due to global budgets, constrained payment flexibility, lower Medicare‑equivalent rates, and bans on duplicate private payments, risking reduced local access to care.
Based on analysis of 22 sections of legislative text.
Establishes a national Medicare‑for‑All program covering all residents, replaces Medicare/Medicaid/CHIP for covered services, and funds it via a Universal Medicare Trust Fund.
Creates a national Medicare-for-All program that provides comprehensive health care benefits to all U.S. residents, administered by HHS, with enrollment and benefit rules to take effect two years after enactment and limited transitional coverage beginning one year after enactment. It replaces existing federal health coverage payments (including Medicare, Medicaid, CHIP, Exchanges, and many value‑based payment authorities) for services covered under the new program, establishes a Universal Medicare Trust Fund as the primary financing vehicle, and sets national rules for benefits, provider participation, quality measurement, data reporting, and regional administration. The law guarantees non‑discrimination and freedom of choice of participating providers, requires HHS to issue detailed regulations and annual reports, creates budgeting and trust‑fund governance structures, imposes ERISA and workers’ compensation coordination rules, and phases out overlapping federal health program authorities during the two‑year transition period. It also preserves certain tribal and VA/IHS benefits and includes compliance, audit, and enforcement provisions and private civil remedies for discrimination claims.