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Introduced April 29, 2025 by Bernard Sanders · Last progress April 29, 2025
Creates a nationwide single‑payer health system that provides comprehensive medical, mental health, reproductive, long‑term care, and other health services to all U.S. residents. The program phases in benefits (children first, full benefits by the fourth calendar year after enactment), ends duplicative federal programs and ACA exchanges once active, sets provider participation rules and global hospital payments, bans routine cost‑sharing (with a narrow prescription‑drug exception), and funds care through a new Medicare for All Trust Fund and revenue changes.
The bill would deliver universal, no-cost-at-point-of-care comprehensive health coverage and stronger equity and quality protections for nearly all residents, but it requires major federal funding, ends most duplicate private/employer coverage, and creates large transition, state fiscal, and provider-participation risks.
All U.S. residents (including uninsured and underinsured people) would gain comprehensive, guaranteed health coverage for inpatient/outpatient care, prescription drugs, mental health, reproductive care, maternity/newborn care, and long-term care with centralized enrollment and ID issuance, reducing coverage gaps and simplifying access.
Enrollees face no patient cost-sharing for covered services, bans on balance billing, and explicit out-of-pocket caps (e.g., drug caps and Medicare transition caps), substantially reducing medical financial risk for low- and middle-income households and people with high health needs.
The federal program centralizes benefits, appeals, quality reporting, and creates a single national enrollment/benefit structure (including a Beneficiary Ombudsman and regional offices), simplifying claims resolution and enabling consistent national standards and oversight.
Most private duplicate coverage and employer-sponsored benefits would be prohibited, ending many employer plans and COBRA continuation mechanisms and requiring millions of workers and employers to transition off existing coverage.
The large expansion of federally guaranteed benefits and creation of a dedicated Trust Fund will substantially increase federal spending and likely require new revenue, transfers, or tax changes, affecting taxpayers and federal budget priorities.
States face significant fiscal and administrative pressure from shifted funding rules (loss of current federal Medicaid/CHIP funding for covered services), maintenance-of-effort floors, and limits on tightening eligibility, which could force state budget reallocations or service trade-offs.