The laws proposed are not necessarily identical year-over-year.
John Conyers' bill The summary of the National Health Care Act as proposed in the 111th Congress (2009–2010) includes the following elements, among others: • Expands the
Medicare program to provide all individuals residing in the
50 states,
Washington, D.C., and
territories of the United States with tax-funded health care that includes all medically necessary care. That would include primary and preventive care, prescription drugs, emergency care, long-term care, mental health services, dental services, and vision care. • Prohibits an institution from participating unless it is a public or nonprofit institution. Allows nonprofit health maintenance organizations (HMOs) that deliver care in their own facilities to participate. On the whole, private insurance would be replaced with the new nationalized system for all basic, major care. • Gives patients the freedom to choose from participating physicians and institutions, which, given the coverage of the new national system, would be any institution or clinic in the United States receiving any degree of public funding (the vast majority). • Prohibits a private health insurer from selling health insurance coverage that duplicates the benefits provided under this Act. Allows the private insurers to sell benefits not medically necessary, such as cosmetic surgery benefits. • Sets forth methods to pay institutional providers of care and health professionals for services. Prohibits financial incentives between HMOs and physicians based on utilization. • Establishes the USNHC Trust Fund to finance the Program with amounts deposited: (1) from existing sources of government revenues for health care; (2) by increasing personal income taxes on the top 5% of income earners; (3) by instituting a progressive excise tax on payroll and self-employment income; and (4) by instituting a small tax on stock and bond transactions. Transfers and appropriates amounts that would have been appropriated for federal public health care programs, including Medicare, Medicaid, and the
State Children's Health Insurance Program. Taxes would be paid instead of insurance premiums, as the government (instead of private insurance companies) would be paying for the care under the
single-payer health care. • Establishes a program to assist individuals whose jobs are eliminated (such as within insurance companies) by the simplified single-payer administrative process. • Requires creation of a confidential electronic patient record system. • Establishes a National Board of Universal Quality and Access to provide advice on quality, access, and affordability. • Provides for the eventual integration of the
Indian Health Service into the Program and evaluation of the continued independence of
Department of Veterans Affairs (VA) health programs. • The bill covers treatments starting on the first day of the year that follows one year after the date of passage. • Compensation continues for 15 years to owners of converting for-profit providers for reasonable financial losses.
Pramila Jayapal's bill Pramila Jayapal's Medicare for All Act of 2019, introduced in the House is broadly similar but more detailed Both proposals contain expansive coverage including long-term care and dental care with no
cost-sharing such as coinsurance, deductibles, or premiums, which as of 2019 is unprecedented in the world. Under the House version, funding for institutions such as hospitals would be negotiated with regional directors, while individual providers would be paid a
fee-for-service. Value-based
pay for performance incentives would not be allowed. As of April 2019, the Senate proposal did not include details on how to completely pay for the plan, but Sanders had released a paper listing ideas.
Dean Phillips, the Democratic congressman who challenged Joe Biden for the Party's nomination for President in
2024, endorsed Pramila Jayapal's “Medicare for All” legislation during his
campaign. == Legislative history ==