Introduced by Democratic Representative Rosa DeLauro of Connecticut on October 29, the Medicare for America Act offers an alternative to proposals that would replace most private insurance. It comes as millions of Americans remain uninsured and rising premiums place additional pressure on households.
According to Newsweek, approximately 26.7 million Americans, or 7.9% of the population, lacked health insurance throughout 2025. Employment-based coverage remained the most common arrangement, reaching 53.5% of Americans for at least part of that year.
How the Medicare for America Proposal Would Change Health Coverage
Under the proposed legislation, every U.S. resident would qualify for Medicare for America, with uninsured individuals automatically enrolled. Workers who receive qualifying health coverage through an employer could retain their existing plans or enroll in the expanded federal program instead.
Employers would continue contributing toward coverage when employees choose Medicare for America. Businesses could also offer the federal program directly to their workers, while private employer plans would face additional requirements covering dental, vision and hearing services.
The proposal would eliminate deductibles and limit premiums to 8% of household income. Individuals earning less than 200% of the federal poverty level would pay neither premiums nor out-of-pocket expenses.
Annual out-of-pocket spending would be capped at $3,500 per individual and $5,000 per household. Lower limits would apply to families earning below 600% of the federal poverty level.
Coverage would extend to prescription medications, maternity care, reproductive health services, mental health treatment, substance-use treatment and long-term assistance delivered at home or in community settings.
According to DeLauro’s announcement, the legislation is designed to preserve existing insurance choices while broadening access to federal coverage. “If you like your current employer coverage, you keep it,” DeLauro said. “If you want Medicare, it is yours.”
How the Legislation Would Control Costs and Navigate Congress
Beyond expanding eligibility, the bill would change how healthcare providers and pharmaceutical companies receive payment.
It would establish an all-payer rate-setting system requiring participating providers to accept Medicare for America reimbursement rates from employer-sponsored plans and Medicare Advantage insurers.
Payments for primary care and mental health services would increase by at least 30%. The legislation would also introduce site-neutral payments and measures targeting Medicare Advantage overpayments.
Federal officials would negotiate prices for all covered prescription drugs, with competitive licensing available when manufacturers reject negotiated prices considered fair under the legislation.
Funding would partly come from repealing the One Big Beautiful Bill Act and introducing additional taxes on higher earners, including a 5% surtax on income exceeding $500,000.
According to Newsweek, the bill, designated H.R. 10924, has been referred to six House committees, including Ways and Means and Energy and Commerce. Its legislative prospects remain limited. DeLauro is currently its only sponsor, and Republicans control both congressional chambers.
The proposal also differs from Representative Pramila Jayapal‘s Medicare for All Act, introduced in April 2025, which would prohibit duplicative private coverage. Jayapal’s measure has attracted 118 Democratic cosponsors, while DeLauro’s latest proposal has none. Both remain legislative proposals rather than enacted healthcare policy.
