How Much Would Medicare for All Cost? (2026)

Direct Answer: Would Medicare for All Save Money or Cost More?

It depends on the estimate and what it measures. The Congressional Budget Office found in 2020 that a plan resembling today's Medicare for All Act could cut national health spending by $650 billion by 2030. A 2026 Yale School of Public Health preprint projects $1.04 trillion in yearly savings, while a 2026 American Action Forum analysis instead projects a $47.4 trillion net federal cost from 2027 to 2036.

What Medicare for All Would Actually Change

Medicare for All, as written in the 2025 bill (H.R. 3069 in the House, S. 1506 in the Senate), would fold Original Medicare, Medicare Advantage, Medigap, ACA marketplace plans, employer-sponsored insurance, and most of Medicaid into one federal program. Everyone legally present in the United States would be automatically enrolled, with no premiums, no deductibles, and no copays for covered services. The current split between Medicare Part A (hospital), Medicare Part B (physician and outpatient), and Medicare Part D (prescription drugs) would disappear into a single comprehensive benefit that also adds dental, vision, hearing, and long-term care, benefits Original Medicare does not fully cover today.

Private insurance would not simply shrink, it would be largely prohibited from duplicating the public plan's benefits. Medicare Advantage plans, which about half of Medicare's 68 million beneficiaries currently choose for lower out-of-pocket costs, would be phased out. Standalone Medigap policies, which 2026 Medicare beneficiaries buy to cover Original Medicare's cost-sharing, would no longer have a purpose because cost-sharing would not exist. ACA-compliant marketplace plans, built around the ACA's 10 essential health benefits and preexisting-condition protections, would also be replaced, since Medicare for All would guarantee those same protections directly through the federal plan.

Why the Estimates Differ So Much

The single biggest reason estimates range from $650 billion in annual savings to $47.4 trillion in added federal cost over 10 years is what each study counts. Federal budget cost measures only the new checks the U.S. Treasury would have to write; it goes up sharply under Medicare for All because employer premiums, individual premiums, and out-of-pocket costs that used to flow through private companies would instead flow through the government. Total national health expenditure measures every dollar spent on healthcare no matter who pays it, and several studies, including the Congressional Budget Office's 2020 low-cost option and the 2026 Yale School of Public Health preprint, find that number could fall because of lower administrative overhead and Medicare-level provider payment rates.

The second big driver is the assumed payment rate to doctors and hospitals. Medicare currently pays providers roughly 60% to 80% of what private insurance pays for the same service, according to CBO's 2020 working paper. Estimates that assume all providers get paid at Medicare rates (like the Mercatus Center's 2018 projection of $32.6 trillion in new federal spending over 2022 to 2031) produce lower total costs than estimates that assume providers would need higher payment rates to keep participating, or that patients would use significantly more care once cost-sharing disappears.

What Medicare for All Would Cost You Personally

For an individual family, the math looks different from the federal budget math. The 2025 KFF Employer Health Benefits Survey found the average family premium for employer coverage reached $26,993 in 2025, with workers paying $6,850 of that directly out of their paychecks, on top of deductibles and copays. Under most Medicare for All proposals, that family would pay $0 in premiums, deductibles, or copays for covered care, but would instead pay higher payroll and income taxes under the financing framework Senator Sanders has proposed, which includes a 4% income-based premium on households earning over $29,935 and new taxes on investment income and large employers.

Whether a given household comes out ahead depends entirely on its current insurance costs and income. A family already paying $6,850 a year toward premiums plus thousands more in deductibles and copays could plausibly pay less under a payroll-tax-funded system with no cost-sharing. A high earner with employer coverage and low medical use could pay more in new taxes than they currently pay in premiums. No official CBO score of the 2025 Medicare for All Act's tax provisions exists as of 2026, so household-level comparisons remain estimates from advocacy groups on both sides.

Where the Medicare for All Act Stands in Congress (2026)

Senator Bernie Sanders, Representative Pramila Jayapal, and Representative Debbie Dingell reintroduced the Medicare for All Act on April 29, 2025, as S. 1506 in the Senate and H.R. 3069 in the House of the 119th Congress. As of June 2026, the House bill has 114 cosponsors, about 54% of House Democrats, and the Senate bill has 16 original cosponsors. Neither chamber's Republican majority has scheduled a committee markup or floor vote, and Congress.gov shows no CBO cost estimate has been requested or published for this version of the bill as of 2026.

The bill would phase in over several years: people age 18 or younger, age 55 or older, or already on Medicare could enroll starting one year after enactment, with a broader buy-in for everyone else at the same time before full implementation. Because the bill has not moved out of committee, none of these dates are locked in, and the cost estimates in this article describe what economists project would happen if the bill passed roughly as written, not a confirmed budget outcome.

Coverage Options Available Today While Medicare for All Remains a Proposal

Medicare for All is not current law, so anyone shopping for coverage in 2026 still has to choose among the existing programs it would replace. Five real options exist right now:

• Original Medicare (Part A and Part B) for people 65 and older or with qualifying disabilities, with optional Part D drug coverage and a $283 annual Part B deductible in 2026.
• Medicare Advantage, private plans that bundle Part A, Part B, and usually Part D, often with extra dental, vision, and hearing benefits and a $0 premium in many counties.
• Medigap, standalone supplemental policies that cover Original Medicare's deductibles and coinsurance for an added monthly premium.
• ACA-compliant marketplace plans at HealthCare.gov, which must cover the 10 essential health benefits and cannot deny coverage or charge more for a preexisting condition, with premium tax credits available based on income.
• Medicaid and CHIP for low-income adults, children, and people with disabilities, income-based and available with no federal enrollment window.

How to Get Covered in 2026 While You Wait

Four steps cover most situations in 2026, regardless of what happens to the Medicare for All Act:

• Check Medicare eligibility and enroll at Medicare.gov if you are 65 or turning 65, or already receiving Social Security Disability Insurance.
• Compare ACA marketplace plans at HealthCare.gov during Open Enrollment, November 1, 2026 through January 15, 2027, for 2027 coverage, or check whether a qualifying life event opens a Special Enrollment Period now.
• Apply for Medicaid or CHIP through your state Medicaid agency at any time; there is no enrollment window.
• Track the Medicare for All Act's status at Congress.gov under bill numbers H.R. 3069 and S. 1506 if the outcome of the legislation affects your planning.

Does Medicare for All replace Original Medicare, Medicare Advantage, and Medigap?

Yes. The 2025 Medicare for All Act (H.R. 3069 / S. 1506) would fold Original Medicare's Part A and Part B into one expanded federal plan, phase out Medicare Advantage, and eliminate the need for Medigap because there would be no deductibles or coinsurance left to supplement. It would also add dental, vision, hearing, and long-term care, benefits Original Medicare does not fully cover in 2026.

How much would Medicare for All cost the federal government?

Estimates vary widely. The American Action Forum projects a $47.4 trillion net federal cost from 2027 to 2036, while the Mercatus Center's 2018 study projected $32.6 trillion over 2022 to 2031. Both count nearly all U.S. health spending as new federal spending once premiums and employer contributions move onto the government's books, which is why the numbers are so large.

Would Medicare for All save money overall?

Some studies say yes. The Congressional Budget Office's 2020 low-cost option found $650 billion in national health spending savings by 2030, and a 2026 Yale School of Public Health preprint projects $1.04 trillion in annual savings from lower drug prices, less administrative overhead, and reduced unnecessary care. These figures measure total national spending, not federal budget cost, which is why they can show savings even when federal costs rise.

What would happen to my employer health insurance under Medicare for All?

It would be phased out. The bill largely prohibits private insurance from duplicating the federal plan's benefits, so employer-sponsored coverage, which averaged $26,993 a year for family plans in 2025 according to KFF, would end. Employees would instead be covered automatically by the federal plan, funded through new payroll and income taxes rather than premium deductions.

Has Congress passed the Medicare for All Act?

No. As of 2026, H.R. 3069 and S. 1506 have not advanced out of committee in either chamber of the 119th Congress, and no floor vote has been scheduled. The House bill had 114 cosponsors as of June 2026, about 54% of House Democrats, but Republican majorities in both chambers control the calendar.

How would Medicare for All be funded?

Senator Sanders's financing framework proposes a 4% income-based premium on households earning over $29,935, higher taxes on investment income, a payroll tax on employers, and increased taxes on high earners and corporations, replacing today's private premiums and out-of-pocket costs. Congress has not passed or scored this financing package as of 2026.

What are my coverage options if Medicare for All doesn't pass?

The same programs available today: Original Medicare or Medicare Advantage if you're 65 or older or disabled, Medigap for supplemental coverage, ACA-compliant marketplace plans with premium tax credits at HealthCare.gov, and Medicaid or CHIP if your household income qualifies. None of these require Medicare for All to pass.

Is Medicare for All the same as the ACA public option?

No. Medicare for All would replace private insurance entirely with one federal plan. A public option, a separate proposal Congress has also debated, would add a government-run plan as one more choice alongside private ACA marketplace plans and employer coverage, without eliminating existing insurance options.