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.

legislation

Virginia and Hawaii Introduce PDAB Legislation

The Virginia Senate introduced a bill to establish a Prescription Drug Affordability Board (PDAB) to review drugs with a wholesale acquisition cost (WAC) of $60,000 or more per year or a WAC increase of $3,000 or more in any 12-month period. For drugs deemed to cause an affordability challenge, the legislation authorizes the PDAB to […]
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February 12, 2026

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Solutions

AHIP Shares Update on Plan Progress to Simplify Prior Authorization

AHIP shared progress on the voluntary, multi-year commitments made by AHIP, BCBSA, and leading health plans (including Cigna Healthcare) to streamline and simplify prior authorization. Health plans serving nearly 270 million Americans are participating in this initiative. The 2026 commitments took effect on Jan. 1 and include: reducing the scope of claims subject to prior […]
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February 12, 2026

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legislation

DOL Issues Proposed Rule on Improving Transparency into PBM Fees

Pursuant to President Trump’s Executive Order “Lowering Drug Prices by Once Again Putting Americans First,” the Department of Labor’s (DOL’s) Employee Benefits Security Administration (EBSA) issued a proposed rule that would require providers of PBM services and affiliated entities of brokerage and consulting services to disclose direct and indirect compensation to their self-funded ERISA fiduciary […]
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February 12, 2026

EGWP marketplace medicaid Medicare

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