AAF Analyzes Financial Burden of a Single-Payer System

April 9, 2025

EGWP marketplace medicaid Medicare

American Action Forum (AAF) recently published insights into the potential costs of changing the U.S. health care system to a single-payer system, sometimes referred to as “Medicare for All” (M4A). Over the past decade, numerous Democrats have proposed that patients would be “better off” with a single-payer system, where the federal government is the sole payer for health care services.

AAF’s new financial analysis of two popular M4A proposals follows a series of “Reality Check-Up” articles outlining other issues and inefficiencies with single-payer systems. Noting that “sometimes, good policy can be unpopular – while bad policy can be popular, as it is here,” AAF argues that the “astoundingly expensive” cost (multi-trillion dollars above the current health care expenditures) of M4A “should rule it out of consideration.” For example, Kamala Harris’s M4A proposal while running for president in 2020 was projected to cost $4.1 trillion, nearly double the cost of Social Security benefits and “dwarfs even national security” spending.

AAF concludes by noting “even doubling all current federal income and corporate taxes would not fully cover the estimated cost of M4A,” making such a system unsustainable.

perspectives

Americans continue to be satisfied with employer-sponsored coverage

A new national survey commissioned by AHIP finds American workers hold consistently positive views of employer-sponsored health coverage, with nearly 9 in 10 expressing satisfaction with their plans and a decisive 96% valuing the financial security their coverage provides. Workers view employer-provided coverage as integral to their employment decisions, with 68% ranking health insurance as […]
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April 15, 2026

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Solutions

AHIP and BCBSA provide progress update on prior authorization commitments

On April 7, The Cigna Group joined other health plans in announcing an update on the industry’s progress implementing the voluntary prior authorization commitments made in partnership with the Department of Health and Human Services and CMS last year. Since June 2025, participating health plans have eliminated 11% of prior authorizations across a range of […]
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April 15, 2026

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legislation

Washington lawmakers pass tax increase impacting insurers

Since returning in January, Washington lawmakers have been busy advancing a variety of tax increases to help manage significant budget shortfalls and introduce new revenue streams. One new source of revenue approved by both the Senate and House and included in the state’s budget is HB 2487, which removes a tax exemption for health plan-affiliated […]
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April 15, 2026

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