RESEARCH: The Urban Institute The Sanders Single-Payer Health Care Plan The Effect on National Health Expenditures and Federal and Private Spending

The Sanders Single-Payer Health Care PlanPresidential candidate Senator Bernie Sanders has called for adopting a single-payer health care system in the United States.1He proposes replacing the programs established under the Affordable Care Act (ACA), as well as preexisting public programs such as Medicaid and Medicare, with the new system. Under his approach, all individuals in the United States would be covered by a single insurance program. Sanders’s plan would eliminate all private spending and replace all private and public coverage programs, except Veterans Health Insurance and the Indian Health Service. Benefits provided under the insurance plan would cover all medically necessary services, and cost sharing would be eliminated entirely. Coverage would include both acute and long-term care.

We analyze the effects of Sanders’s approach on spending by governments, households, and employers, using information publicly provided by the campaign and making our assumptions explicit where detailed information is not available. In companion work, the Urban-Brookings Tax Policy Center estimated the revenue effects of the same proposal (Sammartino et al. 2016). Highlights from the revenue analysis, available in its entirety separately, are referenced here.