Action Memo on Universal Health Care Coverage

Written by Adam Knopsnyder

In order to implement a single payer healthcare system in the United States, a bill must be passed in both houses of Congress and then signed into law by the sitting president. Currently, under the 116th Congress, Representative Pramila Jayapal introduced bill H.R. 1384 on February 27, 2019, which has come to be known as Medicare for All (“Health Care Archives,” n.d.). If signed into law, this Medicare for All bill would transition all Americans from their current private health care or Medicare plans to a new single payer plan operated by the federal government. This memo aims to explain the basic outline and implementation process for the Medicare for All bill.

As written in H.R. 1384, Medicare for All would be the most comprehensive health care coverage in the history of the United States by offering benefits such as: hospital services, including inpatient, outpatient, and 24-hour emergency care; ambulatory patient services; primary and preventive services, including chronic disease management; prescription drugs and medical devices; mental health and substance abuse treatment; laboratory and diagnostic services; women’s reproductive, maternity, and newborn care; pediatrics; oral health, audiology, and vision services; rehabilitative care; necessary transportation to receive health care services for persons with disabilities or low-income individuals; and long-term care services and support (Jayapal, 2019). All of these health care services could be utilized by Americans without having to provide any direct payment at the time of service. Instead, the government would enact a national health budget and create a universal Medicare trust fund to finance the healthcare system of the country (Jayapal, 2019). The national health budget would be funded at first by the current Medicare and Medicaid budgets and through the buy-in transition that will take place over two years. Eventually, once every American is covered by the national system, taxation would continue to sustain the universal Medicare trust fund to provide quality health care.

Once passed into law, the Medicare for All bill would create a new federal department and cabinet secretary position that would be responsible for the administration of the new nationwide healthcare system. This new department would automatically enroll all Americans into the single payer system who are either 19 years of age or younger, or those who are 55 years of age and older (Jayapal, 2019). For the rest of Americans who are between the ages of 20 and 54, there would be a period of two years’ time in which individuals would have to buy into the Medicare for All program (Jayapal, 2019). Over this two-year period, there is a number of ways that Americans can buy into the program. Two main options for transition buy-in include having an individual person pay the cost out-of-pocket to join to government system or having entire companies buy into the national program, which would automatically take all of its employees out of their private health insurance and enroll them into the Medicare for All program, which is known as an exchange (Jayapal, 2019). Regardless of buy-in option, after the period of two years, all Americans would be covered under the government system and anyone born in the US would automatically be enrolled, creating universal health care coverage in the United States of America.  


Health Care Archives. (n.d.). Congresswoman Pramila Jayapal. Retrieved October 19, 2020, from

Jayapal, P. (2019, February 27). Text – H.R.1384 – 116th Congress (2019-2020): Medicare for All Act of 2019 (2019/2020) [Webpage].

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