The two most extensive public health insurance programs in the United States, Medicare, and Medicaid, began in 1965. They generated plenty of controversy at the time of inception and sometimes still do. Most Americans believe the government should provide health insurance options and generally support Medicare and Medicaid.

Only specific populations qualify for these and other government programs, and many Americans still struggle with healthcare costs. Some politicians have called for a national health plan called Medicare for All, which could democratize access to healthcare. Others criticize the idea of universal healthcare in the United States as too expensive and problematic.

What is Medicare for All?

Medicare for All would replace some if not all programs listed below with a federal, single-payor, nationwide health insurance plan. Instead of enrolling in today’s Medicare, private health insurance, or other plans, every American would seek medical coverage through a universal health plan.

The health insurance plans listed below could be impacted by Medicare for All:

  • Medicare: This federal program offers health insurance to people over 65 and some younger disabled people. Beneficiaries may enroll in Original Medicare and private Medicare-regulated insurance plans, like Medicare Advantage or Medicare supplements.
  • Medicaid: States and the federal government cooperate to offer this health insurance plan to low-income Americans, but qualification rules vary by state. Typically, private insurers administer the benefits.
  • gov: The Affordable Care Act (ACA) offers guaranteed-issue private health insurance with mandated benefits for qualified Americans. The ACA also provides subsidies to people with modest incomes who don’t have access to group policies from work. The ACA varies somewhat by state, with some states relying on and others offering their own state-run marketplaces.
  • Private health insurance: Private companies offer health insurance to individuals, families, and workplaces.
  • TRICARE: This VA program offers health services to the military.

Since current options, like Medicare, don’t cover every medical service, private supplemental medical plans would most likely still exist as options for people who can and want to pay for them. The program would leave the VA intact but could replace TRICARE. Also, even though politicians call the plan Medicare for All, it probably wouldn’t look exactly like today’s Medicare.

Medicare for All would need to incorporate aspects of programs that serve various populations into one universal medical plan. For instance, Medicare doesn’t offer specific maternity or pediatric benefits, but Medicaid and CHIP do. Medicare doesn’t cover long-term care, but Medicaid does.

Pros and Cons of Medicare for All

This nationwide coverage will cost trillions of dollars in the next few years. Proponents argue that it can save more money than it costs by reducing or eliminating other healthcare spending. For instance, some taxes might increase, but people and companies wouldn’t need to pay premiums and additional healthcare costs.

According to a survey from the Society for Human Resource Management, average employers spend over $13,000 per year for each employee, and employee premiums average over $3,000 a year. Employers expect premium costs to increase by 4.7% this year and to keep rising in the future. Employers also express concerns about the burden of premiums on their employees and their own bottom lines.

Since Medicare for All would replace many disparate programs, it could also simplify healthcare coverage and reduce administration costs. It would equalize access to healthcare since, despite various government programs, many Americans still struggle to afford medical bills. Also, significant discrepancies exist in healthcare accessibility exist across income levels.

Some critics express concerns over giving one federal organization so much control over healthcare decisions across the country. Also, critics of Medicare for All worry that nobody can predict the impact of the massive restructuring of the American healthcare system. They also worry that the program won’t end up saving money or that it will restrict choices or limit access.

What Are Alternatives to Medicare for All?

A recent survey by Pew Research found that 63% of American adults believe the government has a responsibility to provide medical care. That figure represents an increase from 59% in 2019. At the same time, about 36% think the government should overhaul the current system into a single-payer plan like Medicare for All. Thus, about two-thirds of Americans think healthcare needs reform, but only about one-third prefer one universal health plan as a solution.

A compromise plan to provide a public option could gain more traction with people concerned about the possible unanticipated pitfalls of entirely revamping the system. This alternative would provide a nationwide public alternative but not necessarily replace any other parts of the current system. For example, employees and employees’ content with their current group medical benefits can keep them, but people or businesses struggling with healthcare costs or dissatisfied with current benefits could consider switching to the public option.

The public option could remain as an accessible alternative and safety net for everybody. A public option might also serve as a transitional step to implementing Medicare for All slowly to ensure the program avoids pitfalls and offers the accessible healthcare it promises. Just as other public programs, like Medicare, have evolved over the years, so might the public option.

Where does Medicare for All Currently Stand?

As of 2022 it is largely a stalled issue with Medicare for All being relegated to candidate debate talking points where senate hopefuls state which side of the issue they fall on.


  1. Health Plan Cost Increases for 2022 Return to Pre-Pandemic Levels, SHRM.
  2. Increasing Share of Americans Favor a Single Government Program to Provide Health Care Coverage, Pew Research Center.