How We'll Pay for M4A

How We’ll Pay for Medicare for All, Compiled by Health Care Justice--NC

In the end, we will easily pay for Medicare for All because we are presently paying
more in aggregate national healthcare spending than Medicare for All will cost. The
total cost will likely decrease by around 10%, meaning that both businesses and
households should, on average, see savings of that magnitude.1

Precisely how we get there will remain unclear until Congress passes a bill, but there
are numerous sources for adequate revenue. In general, everyone above a certain
economic level would pay a variety of progressive taxes, primarily through payroll
deductions. Estimates indicate that those taxes would amount to less than current
healthcare spending for families with annual incomes under $400K (95% of
population).2 Some, who are currently uninsured and pay no premiums,
may pay more than they have so far in healthcare costs, as will wealthy households that
will pay their fair share via progressive taxes.

From the Political Economy Research Institute at Amherst University:1,3

Estimated annual cost of Medicare for All: $2.93T ($3.6T in 2018)*

 Existing public sources of healthcare funds** -$1.88T
Remaining funds to be raised: $1.05T
* - total national healthcare spending
** - including Medicare, Medicaid, and other public health care revenue

Potential annual sources of new funds:1,3,4

• 7.5-8.2% payroll tax or 1.78% gross receipts tax = $390-623B
• 4% income-based premium ($844/yr for $50,000 income) = $350B
• 0.38% tax on net worth above $1M = $193B
• 3.75% sales tax on non-necessities = $196B
o excluding necessities such as food, housing, clothing, education, etc.
• Tax long-term capital gains as ordinary income = $69B
• Raise marginal income tax rates over incomes of $250K
• More progressive estate tax = $25B
• 1% tax on wealthiest 0.1 percent of U.S. households = $130B
The bottom line:
• the United States can easily afford this
• 95% of households will pay less than they currently pay in premiums, copays,
deductibles, and other healthcare spending
• everyone will finally have comprehensive, guaranteed, permanent coverage.

1 Economic Analysis of Medicare for All, Pollin, et al. Political Economy Research Institute report, November 30, 2018. At

2 Funding HR 676: How we can afford a national single-payer health plan. Gerald Friedman, July 31, 2013. At

3 Medicare For All - I like it! How do we pay for it? At

4 Options to finance Medicare for all. At