This table (updated from April 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 (Update April 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 (Sanders) Medicare All people No Taxes (no premiums) Enhanced ACA benefits plus long-term care services with virtually no cost sharing. Medicare payment rates
Medicare Part E (Merkley: S. 2708, Richmond: H.R. 6117) 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 with 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 ACA benefits and reduced cost sharing Medicaid payment rates, Medicare rates for primary care
Public Health Insurance Option (Whitehouse: S. 194 / Schakowsky: H.R. 635) 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 and cost sharing reductions (current law) Negotiated rates which fall between Medicare and average private rates
Medicare X  (Bennet: S. 1970 / Higgins: H.R. 4094) 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 (current law) ACA benefits and cost sharing reductions (current law) Medicare payment rates (with plus up for rural areas)
Medicare Buy-in at Age 55 (Stabenow: S. 1742 / Higgins: H.R. 3748) 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 plus long-term care services, both 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