# Medicare for America Act of 2024
This bill creates a new universal health insurance program called Medicare for America, replacing existing Medicare, Medicaid, and private insurance with a single public system by 2031. Here's what you need to know:
**What the Bill Does**
The bill establishes Medicare for America as a comprehensive public health insurance program covering all U.S. residents and lawfully present individuals. Starting in 2027, it automatically enrolls people and provides extensive benefits including hospitalization, prescription drugs, dental, vision, hearing, mental health services, reproductive health care (including abortion), and long-term care. The program eliminates most cost-sharing, with beneficiaries paying 20 percent of costs for most services (100 percent coverage for preventive care, prescription drugs, and services for children and medically vulnerable populations). Out-of-pocket costs are capped at $3,500-$5,000 annually depending on family size and income.
**Who It Affects**
The bill applies to virtually all Americans. People currently on Medicare, Medicaid, and employer health plans would transition into the new system by specific dates (2029-2031). Private insurance for duplicating benefits becomes illegal. Members of Congress and federal employees are included. Large employers must either offer qualifying health plans covering at least 70 percent of premiums or contribute 8 percent of payroll to the program; small employers have more flexible requirements.
**Funding and Timeline**
The bill is funded through significant tax increases: a 5 percent surtax on income above $500,000, increased Medicare payroll taxes (from 0.9 percent to 4 percent), higher net investment income taxes (from 3.8 percent to 6.9 percent), elimination of Health Savings Account deductions, doubled tobacco and alcohol excise taxes, and a new tax on sugared beverages. Premiums are income-based, with zero cost for households below 200 percent of the poverty line. Implementation begins in 2025-2026 with a transitional public option, with the full Medicare for America program launching in 2027 and replacing existing programs by 2031. The bill also includes provisions for nurse staffing ratios in hospitals, drug price regulation, and restrictions on prior authorization requirements.