Sponsors (18)
I'll give you the short version of this bill.
This is not an official government website.
Copyright © 2026 PLEJ LC. All rights reserved.
Section 1128 of the Social Security Act (42 U.S.C. 1320a–7) is made applicable to the Medicare for All Program in the same manner as it applies to State medical assistance plans under title XIX.
Section 1128A of the Social Security Act (42 U.S.C. 1320a–7a) (civil monetary penalties) is made applicable to the Medicare for All Program in the same manner as it applies to State medical assistance plans under title XIX.
Section 1128B of the Social Security Act (42 U.S.C. 1320a–7b) (criminal penalties) is made applicable to the Medicare for All Program in the same manner as it applies to State medical assistance plans under title XIX.
Section 1124 of the Social Security Act (42 U.S.C. 1320a–3) (disclosure of ownership and related information) is made applicable to the Medicare for All Program in the same manner as it applies to State medical assistance plans under title XIX.
Section 1126 of the Social Security Act (42 U.S.C. 1320a–5) (disclosure of certain owners) is made applicable to the Medicare for All Program in the same manner as it applies to State medical assistance plans under title XIX.
Section 1877 of the Social Security Act (42 U.S.C. 1395nn) (limitations on certain physician referrals) is made applicable to the Medicare for All Program in the same manner as it applies to State medical assistance plans under title XIX.
Adds a new section (section 524) to Part 5 of subtitle B of title I of ERISA prohibiting employee benefit plans from providing benefits duplicative of payment under the Medicare for All Program and requiring workers' compensation carriers to reimburse the Medicare for All Program for workers' compensation services; includes definitions for workers compensation carrier, workers compensation medical benefits, and workers compensation services.
Adds text to subsection (b) specifying that paragraph (3) of subsection (b) shall apply subject to section 524(b) (the workers' compensation reimbursement provision added by this title).
Makes multiple conforming amendments to section 502: strikes paragraph (7); redesignates paragraphs (8), (9), and (10) as paragraphs (7), (8), and (9), respectively; and makes related cross-reference adjustments in subsections (c)(1), (e), and (l)(3)(B).
Conforming amendments to section 514(b): strikes specified text in paragraph (7) and strikes paragraph (8).
And 4 more affected sections...
Creates a national, government-run health insurance program that entitles every U.S. resident to comprehensive medical, behavioral, and long-term care benefits, largely replacing federal payment through Medicare, Medicaid, and the Children’s Health Insurance Program. The law establishes program rules for eligibility, enrollment, provider participation, benefit scope, provider payments (including hospital global budgets and a national fee schedule), and limits most patient cost-sharing while allowing narrowly defined drug cost-sharing. Sets up a dedicated Medicare for All Trust Fund and requires specified revenues and transfers to fund the program; changes ERISA to bar duplicate employer coverage; creates a temporary public plan for the transition period; requires HHS to run the program, set quality standards and data collection on disparities, and coordinate with states and existing programs. The bill phases in benefits at a specified trigger date and includes transition rules to protect certain groups (veterans, TRICARE, Indian Health Service users) and ongoing long-term care arrangements that existed on Jan 1, 2023.
Establishes a national health insurance program called the "Medicare for All Program" to provide comprehensive protection against the costs of health care and health-related items and services in accordance with standards in or established under the Act.
Every individual who is a resident of the United States is entitled to benefits for health care items and services under this Act; the Secretary must promulgate a rule that provides criteria for determining residency for eligibility purposes.
The Secretary may make other individuals (not residents) eligible for benefits and regulate their eligibility to ensure that every person in the United States has access to health care.
The Secretary must promulgate a rule, consistent with Federal immigration laws, to prevent an individual from traveling to the United States for the sole purpose of obtaining health care items and services provided under this Act.
Any individual entitled to benefits may obtain health care items and services from any institution, agency, or individual qualified to participate under this Act (freedom of choice).
Who is affected and how:
All U.S. residents and patients: Every resident becomes entitled to benefits under the new Program, with most covered services provided with little or no cost-sharing. This reduces out-of-pocket costs for many patients but changes how they access care (enrollment rules, Program ID cards, limitations on private duplicates).
Health care providers and facilities: Hospitals, clinics, physicians, long-term care providers, behavioral health providers and others must meet Program participation requirements, sign participation agreements, accept new payment methods (global budgets for facilities; a national fee schedule for individual providers), and comply with quality and reporting rules. Provider revenue mixes will change, and some administrative and contracting practices will be constrained by strict limits on private contracts and uses of Program payments.
Private insurers and employer-sponsored plans: Employer and other private plans will be barred from duplicating Program coverage; ERISA changes will remove or limit some employer plan roles and may require plan redesign or cessation of duplicate coverage. Employers that previously provided health benefits will face legal and operational changes; workers’ compensation carriers must reimburse the Program for covered services.
Federal programs and beneficiaries: Federal payment flows through Medicare, Medicaid, and CHIP largely shift into the new Program, affecting beneficiaries who currently receive those benefits (including seniors and low-income enrollees). The law preserves protections for certain groups (veterans, TRICARE beneficiaries, Indian Health Service users) and preserves some state Medicaid long-term care arrangements that existed on Jan 1, 2023.
State governments: States must coordinate with HHS to identify services exempted from the shift and to implement transition processes; some state responsibilities for Medicaid payments will change. State budgets may be affected by changes in Medicaid payment roles and by compliance/coordination costs.
Pharmaceutical and medical supply makers: Negotiated pricing authority and national purchasing/price-setting provisions can reduce prices received by drug and device manufacturers; narrow drug cost-sharing remains for patients.
Federal agencies and HHS: HHS will take on major new administrative, rulemaking, oversight, and enforcement responsibilities, including setting the national budget, establishing payment systems, operating regional offices, monitoring quality, and implementing data collection on disparities.
Fiscal and macroeconomic effects: The legislation establishes a Trust Fund funded by specific revenues and transfers (including amounts equal to current federal health spending adjusted for inflation and other factors). It therefore restructures federal health financing and creates significant fiscal management and transition challenges. Implementation will likely require tax changes and new administrative capacity, with broad economic effects on labor market compensation, employer costs, and state/federal budgets.
Transition and legal risks: The policy creates large-scale structural changes (ERISA changes, ending Exchanges, reassigning federal payment flows) that will require detailed regulatory guidance and may face legal and implementation challenges. Provider behavior, private insurer responses, and litigation could affect the pace and completeness of implementation.
Expand sections to see detailed analysis
Read twice and referred to the Committee on Finance.
Introduced April 29, 2025 by Bernard Sanders · Last progress April 29, 2025
Read twice and referred to the Committee on Finance.
Introduced in Senate