Medicare for All Act

Summary

Establishes a nationwide single-payer health insurance program that makes every U.S. resident eligible for a comprehensive set of medical benefits with no patient cost-sharing for most services, creates a new Medicare for All Trust Fund to pay for benefits, and phases in coverage with special early coverage for children. It prohibits duplicate private coverage of covered services, sets national provider participation rules and quality standards, requires new national budgeting and data/reporting systems, and adjusts related federal programs (Medicare, Medicaid, CHIP, ERISA-regulated plans, SSI) to coordinate with the new program. The law phases in benefits (children first, full population later), bans most out-of-pocket charges for covered care while allowing a limited prescription drug copay schedule and supplemental private coverage, requires automatic enrollment and issuance of an ID card, and includes enforcement, anti-discrimination, whistleblower protections, and reporting and cost-containment mechanisms administered by HHS/CMS under new national standards.

• Creates a nationwide single-payer health insurance program covering nearly all medically necessary services for every U.S. resident with automatic enrollment.
• Bans most patient cost-sharing; allows a limited prescription drug copay schedule with low-income and preventive exemptions.
• Prohibits duplicate private coverage for covered services but allows limited supplemental coverage and narrowly defined private opt-outs in emergency or consented situations.
• Establishes a new Medicare for All Trust Fund and directs large transfers/appropriations from existing federal health program spending and specified revenue sources.
• Ends Medicare Part A/B entitlement and federal Medicaid/CHIP payments for items/services covered by the new program when benefits begin, while preserving institutional long-term care under Medicaid.
• Sets national provider participation standards, whistleblower protections, reporting requirements, and a national quality and data infrastructure run by HHS/CMS.
• Creates an annual national health budget and other cost-containment and payment mechanisms to control program spending.
• Changes ERISA rules to bar duplicative employer plans, requires workers’ comp carriers to reimburse the new program, and repeals some ERISA continuation coverage provisions.
• Makes targeted improvements to Medicare (out-of-pocket cap, dental/vision/hearing coverage, lower Part D threshold) with some provisions effective before full rollout.
• Increases SSI resource limits and ties future adjustments to existing COLA mechanisms beginning in 2025.