Medicare for All Would Limit Family Health Choices

I have spent more than 25 years as an OB-GYN delivering babies in Virginia, and eight years in the state Senate working to lower health costs. Both jobs taught me that families make better health decisions than Washington does. That is why a revived push for Medicare for All worries me.

Over half the House Democratic caucus has co-sponsored Medicare for All legislation. In July, the Congressional Progressive Caucus hosted a shadow hearing on it, where its chair called passage "one of the top priorities" of the Progressive Caucus. In Michigan's Senate race, Democrat Abdul El-Sayed ran explicitly to deliver it. Democrat Maine Senate Candidate Troy Jackson admitted the truth they keep trying to hide, “On Medicare for All, there’s people who are arguing, ‘well, can I keep my healthcare?’ Well, no you can’t.”

One thing is clear from the 2026 midterm elections. Americans remain deeply concerned about the cost of living and healthcare. Democrats are likely to interpret their victories as an opportunity to advance a more expansive federal role in health care, including Medicare for All. But Democrats should not mistake Republican losses for an endorsement of a government takeover of all healthcare. The country deserves an honest conversation about what this proposal would mean for American families.

Medicare for All doesn't expand Medicare. It replaces private coverage with a single government plan. Washington would decide what your family's care costs, what gets covered, and who gets paid. Your family would have no say.

That includes Medicare Advantage, which would not survive. Medicare for All bars private insurers from offering coverage that duplicates the government plan's benefits. More than 34 million seniors and people with disabilities, over half of all eligible beneficiaries, have chosen these plans. They chose them for the extras traditional Medicare lacks: dental, vision, and hearing coverage, an out-of-pocket spending cap, care coordination, and in many plans, gym memberships and help with transportation. Seniors who picked their coverage would lose it, whether or not they wanted to.

The price is enormous. An American Action Forum (AAF) analysis models a single-payer plan on the Medicare for All template, using the Center for Health and Economy's microsimulation. It projects a net federal cost of $47.4 trillion from 2027 to 2036, rising to roughly $5.9 trillion a year by 2036. That is before any new taxes. It also leaves out dental, vision, and hearing benefits, so it is a floor. An earlier Mercatus Center analysis of the Sanders bill estimated about $32.6 trillion in new federal commitments over a decade. Its author called that conservative, because it assumes the bill succeeds in cutting provider payments and drug prices. Even doubling all projected individual and corporate income tax collections would not cover it.

I have run a medical practice and helped launch Central Virginia’s first OB hospitalist program to improve safety and efficiency in maternity care, so I know what it costs to deliver care. The Mercatus analysis found the bill would cut payments to providers by more than 40 percent relative to private insurance rates. That is below what it costs to deliver care, and demand for services would surge. Nobody knows how many hospitals and practices would cut services or close. Families feel it when a labor and delivery unit or a pediatric practice shuts its doors. That is a large risk to impose on a system that serves 330 million people.

Supporters say the taxes will pay for it. AAF tested that using the financing options in the Sanders framework: employer and household income taxes, a health care tax, progressive income taxes, a wealth tax, an estate tax, and an S-corporation tax. Those taxes raise $1.7 trillion in 2028 against a $4.1 trillion cost. That leaves a $2.4 trillion gap in a single year and about $19 trillion cumulatively from 2028 to 2036. Closing it would take more taxes on workers, employers, and investors, which could change labor supply, wages, and investment. The same model assumes the plan covers undocumented immigrants, consistent with Kamala Harris's 2019 proposal.

This push isn't stopping with one bill. House Democrats are discussing a major expansion of Medicare coverage and government-run insurance if they win the House. Their healthcare working group included Medicare for All in its report to Democrat Leader Hakeem Jeffries.

The conversation ahead should begin with three questions for every Democrat member of Congress. How will you make health care more affordable for American families? Will you protect patients' ability to choose their own coverage and doctors? And how will you strengthen Medicare for the seniors who have earned it?