New research from HEAL Network Founding Director, Dr. Stephen Parente examines the potential effects of a Medicare for All proposal on health coverage, provider access, medical productivity, and the federal budget.
The analysis, published by the American Action Forum’s Center for Health and Economy, updates an earlier assessment using revised microsimulation projections covering the period from 2027 through 2036. It also evaluates how the proposal compares with recent estimates suggesting that a single-payer system could significantly reduce national health spending and prevent thousands of deaths annually.
Dr. Parente finds that Medicare for All could achieve effectively universal insurance coverage. However, it also highlights important questions about the proposal’s financing, effects on health care utilization, provider capacity, and the distinction between national health spending and federal budgetary costs.
Key Findings
- The uninsured population would fall from approximately 13 million in 2027 to zero beginning in 2028, as employer-sponsored insurance, individual-market coverage, and Medicaid are absorbed into a new federal program.
- Medical productivity would decline by an estimated 14 percent in 2027 and 22 percent by 2036 compared with the current-law baseline. The analysis attributes this projected decline in part to the elimination of network-based cost controls and patient cost sharing.
- Provider access would improve by an estimated 12 percent in 2027 and 19 percent by 2036, assuming the supply of physicians and other providers keeps pace with increased demand for care.
- The proposal would carry a cumulative net budgetary cost of approximately $47.4 trillion from 2027 through 2036 before new revenues are applied.
- Even after accounting for proposed financing mechanisms, including employer and household income taxes, wealth and estate taxes, and other revenue sources, the analysis projects a cumulative budgetary shortfall of approximately $19 trillion from 2028 through 2036.
- The research emphasizes that universal insurance coverage does not necessarily guarantee timely access to physicians, hospitals, specialists, or other health services.
- The analysis also cautions that national health expenditure savings should not be confused with federal budget savings. A plan could reduce some forms of health spending while shifting a much larger share of health care costs onto the federal government.
Overall, the research underscores the importance of evaluating Medicare for All proposals across multiple dimensions, including whether they expand coverage, how they affect provider capacity and health care productivity, and their implications for federal spending, taxation, and access to care.
Read the full report: “Medicare for All: An Updated Coverage and Budget Analysis.”