Comparing Recent Health Care Proposals: From building on the ACA to Medicare for All

May 13, 2019

A yellow road sign reading, "Health insurance changes ahead," indicating changes due to the health care proposals the author is comparing.Democratic lawmakers in Congress have made a variety of proposals to strengthen or reform the United States health care system. These proposals range from building upon the Affordable Care Act (ACA) to fully transitioning the U.S. to a single-payer system. This fact sheet categorizes and compares the major provisions of these proposals, including possible implications for consumers, health care providers, and federal and state governments.

The proposals that the fact sheet compares are: ACA 2.0, which increases Marketplace financial assistance, restores outreach and assistance funding, and creates a reinsurance program; Public Option, which creates a publicly-administered health insurance plan offered for purchase on the Marketplace; Medicaid Buy-In, which provides certain individuals with the opportunity to purchase Medicaid coverage; Medicare Buy-In, which provides certain individuals with the opportunity to purchase Medicare coverage; Medicare for America, which provides an option and incentives for all US citizens to switch to Medicare coverage; and Medicare for All, which replaces the current health insurance system with universal Medicare coverage for all U.S. citizens.

For each health care proposal, the sheet considers who would be affected, what would be covered, what cost-sharing would look like, how it would impact other types of coverage, how it could impact health care providers, how it would be financed, and how much it could cost. The fact sheet also lists the specific bills and proposals for each health care option.

This fact sheet combines information on all the recent health care proposals in a straightforward, objective format so the proposals can easily be compared and considered.