Senator Bernie Sanders of Vermont and Democratic Representatives Pramila Jayapal of Washington and Debbie Dingell of Michigan reintroduced the Medicare for All Act on Tuesday, reviving a push to create a single-payer healthcare system at a moment when Republican lawmakers are advancing proposals to slash Medicaid by as much as $500 billion.
The progressive legislation, long championed by Sanders and backed by a growing number of lawmakers, aims to create a government-run healthcare system that would replace private insurance with a universal plan covering all Americans. The bill’s return to Congress was marked by a rally in front of the Capitol, where Sanders and his colleagues were joined by hundreds of nurses, healthcare providers, and workers from across the country.
“We have the radical idea of putting healthcare dollars into healthcare, not into profiteering or bureaucracy,” Sanders said at the press conference. “A simple healthcare system, which is what we are talking about, substantially reduces administrative costs, but it would also make life a lot easier, not just for patients, but for nurses.”
“So let us stand together,” Sanders continued. “Let us do what the American people want and let us transform this country. And when we pass Medicare for All, it’s not only about improving healthcare for all our people—it’s doing something else. It’s telling the American people that, finally, the American government is listening to them.”
Under Medicare for All, the government would provide comprehensive healthcare coverage for all residents, including dental, vision, prescription drugs, and other services. The bill now has 104 co-sponsors in the House and 16 in the Senate—an increase from the previous Congress, according to Sanders’ office.
“It is a travesty when 85 million people are uninsured or underinsured and millions more are drowning in medical debt in the richest nation on Earth,” Jayapal said in a statement on Tuesday.
Supporters of the bill point to studies showing that a single-payer healthcare system would save money and lives. In 2020, The Lancet published a peer-reviewed study estimating that such a plan would save Americans more than $450 billion annually and prevent around 68,000 deaths each year. That same year, the Congressional Budget Office found that a single-payer system resembling Medicare for All would yield approximately $650 billion in savings by 2030.
Public polling shows strong support for government-guaranteed healthcare coverage. A 2023 Gallup poll found that 70 percent of Democrats support a government-run healthcare system. The same poll found that 57 percent of Americans overall believe the government should ensure that all people have healthcare coverage.
Members of National Nurses United (NNU), the nation’s largest union of registered nurses, were present at Tuesday’s rally and emphasized the bill’s significance amid mounting threats to public health programs.
“The goal of the current administration and their billionaire buddies is to pile on endless cuts and attacks so that we become too demoralized and overwhelmed to move forward,” said Bonnie Castillo, registered nurse and executive director of NNU. “Even on our hardest days, we won’t stop fighting for Medicare for All.”
While progressive lawmakers and healthcare workers were calling for expanded access to healthcare, Republican leaders were advancing proposals to significantly reduce it.
On Tuesday, Representative Don Bacon of Nebraska, a key House Republican, told Politico that his “red line” in budget negotiations was a $500 billion cut to Medicaid over the next decade. The statement quickly drew condemnation from healthcare advocates and policy experts.
“A $500 billion cut to Medicaid is not at all moderate, but massive—the biggest cut in the history of Medicaid, one that would force millions of Americans to lose coverage,” said Anthony Wright, executive director of Families USA.
“Slashing Medicaid by hundreds of billions of dollars would force states like Nebraska to make the unholy choice to drop people from coverage, cut benefits, and/or cut payments to the providers we all rely on, or otherwise raise taxes,” Wright continued. “Medicaid cuts would be another wrecking ball to the health system and to the economy.”
The Century Foundation estimated that a $500 billion cut to Medicaid would eliminate health coverage for more than 18 million children and over 2 million adults with disabilities.
“If your ‘red line’ is taking away healthcare from millions of people, then you don’t have a red line,” said Kobie Christian, a spokesperson for the advocacy coalition Unrig Our Economy.
“Not one dollar should be cut from Medicaid to pay for one dollar of tax breaks for the rich.”
Bacon also expressed support for work requirements for Medicaid recipients, a policy that has failed to increase employment while frequently removing people from coverage. “They should be seeking the skill sets for better jobs,” Bacon said.
According to policy analysts, most Medicaid recipients who are able to work already do so, and adding work requirements has historically succeeded only at cutting enrollment rather than raising employment levels.
Brad Woodhouse, president of Protect Our Care, called out the broader GOP agenda to undermine Medicaid while prioritizing tax breaks for the wealthy. “As the GOP drafts their devastating budget, one thing remains true: Republicans in Congress want to make the largest Medicaid cuts in history to fund tax breaks for the wealthiest Americans,” he said.
“Whether it’s a trillion dollars, half a trillion, or hundreds of billions in Medicaid cuts, no member of Congress can justify ripping healthcare away from some of the most vulnerable Americans to give tax breaks to the wealthy,” Woodhouse added. “Not one dollar should be cut from Medicaid to pay for one dollar of tax breaks for the rich.”
Representative David Valadao of California, a Republican who represents the House district with the highest percentage of Medicaid recipients, also expressed concerns about the scope of the proposed cuts. However, he indicated he was open to capping Medicaid funding for some groups—a move that experts warn could unravel the Affordable Care Act’s Medicaid expansion.
Edwin Park, a research professor at Georgetown University’s McCourt School of Public Policy, said such caps should “be viewed as just another proposal to sharply shift expansion costs to states by lowering the effective expansion matching rates, with the intent of undermining and eventually repealing the Medicaid expansion.”
“That, in turn, would take away coverage from nearly 21 million low-income parents, people with disabilities, near-elderly adults, and others,” Park wrote. “It would also have significant adverse effects on the children of expansion adults: Research shows that the Medicaid expansion increases enrollment among eligible children and therefore reduces the number of uninsured children.”
“And, of course, it would also deter the 10 remaining non-expansion states from taking up the expansion in the future,” he added.
The reintroduction of Medicare for All and the GOP’s simultaneous push to cut Medicaid highlight two starkly different visions for the nation’s healthcare system. One calls for universal, government-funded care aimed at reducing costs and saving lives; the other proposes sweeping reductions to existing coverage programs in order to fund tax cuts for the wealthiest Americans.
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