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Dec. 7, 2021, 9:48 a.m. EST

How would ‘Medicare for All’ affect my health care and finances?

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Alex Rosenberg

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Also read: Medicare is not enough—why so many Americans over 65 can’t afford health care

Could I keep my private insurance or coverage through my employer?

No. El-Sayed says that the federal government would be “buying you out” of your private insurance under Medicare for All. This single-payer model has been championed by Sens. Bernie Sanders and Elizabeth Warren.

Some other health care reform proposals have included a public option, which would allow you to either buy into a government plan or stick with private or employer-provided insurance. The current version of Medicare for All would not offer that option.

After a transition period, private insurers and employers would be prohibited from offering coverage for the same benefits covered by Medicare for All. However, El-Sayed says that there may still be “a few insurance companies that offered a sort of concierge-level service for folks who wanted to pay for that.”

Could I keep my doctor?

Yes. “If Medicare or a national health insurance program is your insurer, and it is the insurer for everyone, then it basically becomes incumbent on every doctor and hospital to accept it,” El-Sayed says. “In fact,” he adds, “your access to whatever doctor you choose to see actually expands.”

The Medicare for All Act of 2021 would require providers, hospitals and clinics to meet certain “national minimum standards” in areas such as quality of facilities, staffing ratios, personnel training and outcomes. Those standards were first established as part of the original Medicare program, so there should be no disruption if your doctor — like most — already accepts Medicare.

Also read: Health care will cost this much in retirement — but probably even more

What would Medicare for All cost?

There are really several questions here:

What would I pay out of pocket?

Nothing. You would not pay anything directly to a health care provider, clinic, hospital or insurer. Tax dollars would pay for all of the services you would receive under Medicare for All. “By eliminating copays and deductibles, people would have access to health care,” Friedman says. “People don’t go to the doctor because they can’t afford it.”

Providers would also be prohibited from sending bills for any remaining charges above the amount they receive from the government — a practice known as balance billing.

Would taxes go up to pay for Medicare for All?

Yes. “The catch is that you would be paying more in taxes…and we’re talking about a big tax increase,” Friedman says. The specifics of the tax arrangements are not yet settled, but Friedman and El-Sayed named income, payroll and wealth tax increases as potential options.

Would I pay more or less overall?

We can’t know yet. Everyone’s existing health care costs are different, and people in different financial situations would see different effects depending on the tax changes under Medicare for All. Depending on the tax funding model and your tax situation, you could end up paying either more or less overall.

Most studies, including Friedman’s own estimates and analysis by the nonpartisan Congressional Budget Office, suggest that overall health care spending would decline under Medicare for All. On the other hand, some models with different assumptions show spending increases instead. For example, a study by the RAND Corp., a nonprofit public policy research organization, suggests that higher demand for health care might outweigh other cost savings, so the country would spend slightly more overall.

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Alex Rosenberg writes for NerdWallet. Email: arosenberg@nerdwallet.com. Twitter: @AlexPRosenberg .

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