In 2019, presidential candidate Kamala Harris designed a replacement for the Affordable Care Act (ACA) using the template of Medicare for All.[1] The replacement (“the Plan” or M4A) is a proposal for a single-payer health program managed by the federal government that has the goal of universal coverage. This report details the findings of the Center for Health and Economy’s (H&E) combined Under-65 and Over-65 microsimulation models on M4A’s impact on health insurance coverage, provider access, medical productivity, and the federal budget. While our estimates are associated with some degree of uncertainty, the summary of our findings is as follows:
KEY FINDINGS:
- Without the need to sign up for insurance and with the promise of all cost sharing and premiums being eliminated, H&E expects universal coverage.
- The health insurance coverage provisions under current law for the non-elderly are estimated to increase federal spending by $43.9 trillion between 2026 and 2035.
- One significant difference in the Harris plan from previous M4A proposals is the explicit funding of health insurance for all undocumented and illegal aliens residing in the United States.[2] The approximate cost of covering an additional 11 million individuals with M4A coverage is $1.8 trillion between 2026 and 2035.