This table (last updated December 10, 2019) compares major public plan proposals for health coverage. It does not include proposals that would inject public plan elements into private plans (for example, through the use of Medicare payment rates in the individual market or reinsurance).

Editor’s note: from March 8, 2019 onwards, the information in this table has been managed and updated by TCF senior fellow Jen Mishory.

Table 1

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How Proposals for Public Health Care Plans Differ (Updated December 2019)
Who Runs the Plan?(Read More) Who Qualifies for the Plan?

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 Can People Choose a Different Plan?

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 What Do Enrollees Pay? What Do Enrollees Get?

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 How Much Do Providers Get Paid?
Medicare for All: S. 1129 (Sanders) Medicare All people No Taxes (no premiums) Enhanced ACA benefits, includinglong-term care services, dental, vision, and reproductive care that includes abortion coverage; virtually no cost sharing Medicare payment rates
Medicare Part E (Merkley: S 1261, Richmond: H.R. 2463) Federal gov’t All non-elderly people except those Medicaid- or Medicare-eligible Depends: Employers choose for workers; yes for others Federal gov’t-set premiums based on costs, decreased for low-income enrollees and employer contribution (current law) Enhanced ACA benefits, including abortion coverage; Gold-plan-level cost sharing Negotiated rates which fall between Medicare and average private rates
Medicaid Option (Schatz: S. 489 / Lujan: H.R. 1277) States All non-elderly people in such States Yes State-set premiums, decreased for low-income enrollees Medicaid benefits plus reproductive care that includes  abortion coverage; reduced cost sharing Medicaid payment rates, Medicare rates for primary care
Public Option/CHOICE Act (Whitehouse: S. 1033 / Schakowsky: H.R. 2085) Federal gov’t People buying coverage on their own and small businesses Yes Federal gov’t-set premiums based on costs; decreased for low-income enrollees (current law) ACA benefits plus abortion as part of reproductive health care; includes cost sharing reductions (current law) Negotiated rates which fall between Medicare rates and average private rates
Medicare X  (Bennet: S. 981 / Delgado: H.R. 2000) Federal gov’t People buying on their own and small businesses, in underserved areas initially Yes Federal gov’t-set premiums based on costs; decreased for low-income enrollees (enhanced ACA tax credits) ACA benefits and cost sharing reductions (current law) Medicare payment rates (with  increase for rural areas)
Medicare Buy-in at Age 55 (Stabenow: S. 1742 / Higgins: H.R. 1346) Medicare People ages 50 or 55 to 64 without access to employer coverage Yes Federal gov’t-set premiums based on costs; decreased for low-income enrollees (current law) Medicare benefits and cost sharing, ACA cost sharing reductions Medicare payment rates
Medicare for All (Jayapal: H.R. 1384) Federal gov’t All people No Taxes (no premiums) Enhanced ACA benefits, including long-term care services, dental, vision, and reproductive care that includes abortion coverage with no cost sharing Lump sum/“global budget” payments (fee schedule for individual providers)
Keeping Health Insurance Affordable Act/Public Option Deficit Reduction Act (Cardin: S. 3/DeFazio H.R. 1419) Federal gov’t All people Yes Federal gov’t-set premiums based on costs; decreased for low-income enrollees (current law) ACA benefits Medicare to start; can vary later
Medicare for America (DeLauro H.R. 2452) Federal gov’t All people Yes, if they have an employer option Federal gov’t-set premiums based on costs; decreased for low-income enrollees Enhanced Medicare and Medicaid benefits, including dental, vision, and reproductive care that includes abortion coverage; reduced cost-sharing Medicare payment rates, with increases for primary care and mental health services

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