Medicare for All Act
Medicare for All Act
Plain Language Summary
# Medicare for All Act Summary **What It Would Do** If passed, the Medicare for All Act would create a single, government-run health insurance program administered by the Department of Health and Human Services that would cover all U.S. residents. The program would automatically enroll people when they're born or become residents. It would cover a broad range of medical services including hospital care, prescription drugs, mental health and substance abuse treatment, dental and vision care, long-term care, and reproductive services. Importantly, the bill would eliminate most out-of-pocket costs like deductibles and copayments for covered services, though prescription drugs would still have some cost-sharing. **Who It Affects and Key Provisions** This bill would affect virtually every American by replacing the current multi-payer system (where multiple insurance companies compete) with a single national program.
Private health insurers could only offer supplemental coverage on top of the government plan, fundamentally restructuring the U.S. healthcare system. The bill also specifies that employers could not offer health coverage as an alternative. **Current Status** The bill (S. 1506) is currently in committee and has not been voted on by the full Senate. Similar versions of this legislation have been introduced in previous congressional sessions.
CRS Official Summary
Medicare for All Act This bill establishes a national health insurance program that is administered by the Department of Health and Human Services (HHS). Among other requirements, the program must (1) cover all U.S. residents; (2) provide for automatic enrollment of individuals upon birth or residency in the United States; and (3) cover items and services that are medically necessary or appropriate to maintain health or to diagnose, treat, or rehabilitate a health condition, including hospital services, prescription drugs, mental health and substance abuse treatment, dental and vision services, home- and community-based long-term care, gender affirming care, and reproductive care, including contraception and abortions. The bill prohibits cost-sharing (e.g., deductibles, coinsurance, and copayments) and other charges for covered services, with the exception of prescription drugs. Additionally, private health insurers and employers may only offer coverage that is supplemental to, and not duplicative of, benefits provided under the program. Health insurance exchanges and specified federal health programs terminate upon program implementation. However, the program does not affect coverage provided through the Department of Veterans Affairs, TRICARE, or the Indian Health Service. Additionally, state Medicaid programs must cover certain institutional long-term care services. The bill also establishes a series of implementing provisions relating to (1) health care provider participation; (2) HHS administration; and (3) payments and costs, including the requirement that HHS negotiate prices for prescription drugs and establish a formulary. Individuals who are age 18 or younger may enroll in the program starting one year after enactment of this bill; other individuals may buy into a transitional plan or an expanded Medicare program at this time, depending on age. The bill's program must be fully implemented four years after enactment.
Latest Action
Read twice and referred to the Committee on Finance.