Medicare for All – Comparison

Economic Bottom Line: None of the four states that have drafted a Medicare for All bill has successfully implemented it. Increases in taxes would bridge the gap between the estimated costs of the proposed programs and the anticipated revenues from federal sources. Legislators and governors have apparently considered the size of the required tax increases to be politically unpalatable, although the tax increases for a single-payer system would be lower than the current costs of private and public healthcare insurance, which would be eliminated.

• Massachusetts – Senate Bill S.744 193rd (2023-2024) Eldridge
• Single Payer: Yes – Massachusetts would become an insurer and offer Medicare Part C (aka Medicare Advantage) to all residents without charge.
• All residents would be covered.
• Funded partly by the federal government through waivers to divert funds provided the state to finance state-run Medicaid.
• Funded partly by increases in individual and employer taxes.
• "The Executive Director shall … use the purchasing power of the state to negotiate price discounts for prescription drugs and all needed durable and nondurable medical equipment and supplies."


• California – Guaranteed Health Care for All Act No. 2200 (April 30, 2024) (aka CalCare)
• Single Payer: Yes – "This bill … would create … CalCare, to provide comprehensive universal single-payer health care coverage."
• All residents would be covered.
• Funded partly by the federal government through waivers to divert funds provided the state to finance state-run Medicaid.
• Funded partly by taxes via "Assembly Constitutional Amendment No. 11 (January 05, 2022), a resolution to propose … an amendment to the Constitution [that] would impose an excise tax, payroll taxes, and a State Personal Income CalCare Tax at specified rates to fund comprehensive universal single-payer health care coverage "
• Prescription drugs: "The prescription drug formulary system shall include coverage for prescription drugs in a manner in which there is no cost sharing for CalCare enrollees."


• Colorado – Colorado House Bill 23-1209 Concerning the Analysis of a Universal Health-Care System (2023)
• House Bill 23-1209 specifies: "The bill requires the Colorado school of public health to analyze model legislation for implementing a publicly financed and privately delivered universal health-care payment system for Colorado that directly compensates providers." It is Colorado's latest consideration of a universal healthcare system, which dates back to at least 2007. (See "Colorado Blue Ribbon Commission For Health Care Reform .")
• The bill delegates responsibility to the school of public health for addressing details, such as whether the universal healthcare system would be single-payer, how the program would be funded, and whether all residents would be covered.
• Vermont – Vermont No.48 An Act Relating To A Universal And Unified Health System (2011) (aka Green Mountain Care)
• Single Payer: Yes – "The general assembly intends to create Green Mountain Care to contain costs and to provide, as a public good, comprehensive, affordable, high-quality, publicly financed health care coverage for all Vermont residents."
• All residents would be covered.
• Funding was only generally addressed in the 2011 bill. Increasing taxes was not addressed.
• The economic analysis on which the governor based his political decision to abandon Green Mountain showed a requirement for increased taxes that he apparently considered to be politically unpalatable. (See "How Vermont's single-payer health care dream fell apart.")
• Prescription drugs: "The Department of Vermont Health Access shall provide recommendations regarding a single prescription drug formulary to be used by all payers of health services professionals prescribing drugs."