Dr. C.D. Casscells is the director of the Center for Health Policy at the Caesar Rodney Institute.
In 2025, Sen. Bernie Sanders, I-Vt., put forward proposed legislation, the Medicare for All Act (Senate Bill 1506), with 15 co-sponsors, which has now grown to 18 co-sponsors. But what does it really mean?
Sanders’ Medicare for All Act would replace Medicare and Medicaid with the Medicare for All Program. TRICARE (the Veterans Administration’s healthcare) and the Indian Health Service, though, would continue to exist. The proposed legislation very clearly states that any health insurance policy now offered that duplicates what is offered under the Medicare for All Program would not be allowed once the new program begins.
What that very specifically means is that your platinum Blue Cross Blue Shield health insurance plan that includes such things as vision care or dental care or a prescription drug plan would simply not be allowed — it would not be made available by any health insurer because it duplicates benefits covered by Medicare for All. No health insurance could continue offering you that plan, regardless of how much you like it or how much you are willing to pay for it.
This would mean the end of existing comprehensive employer-sponsored health insurance plans as employees know them today. The Medicare for All Program itself would cover prescription drugs, dental care and vision services. Unions, including those representing employees of the state of Delaware or the University of Delaware, could still bargain for additional benefits not covered by the Medicare for All Program but not duplicative drug, dental or vision coverage. All employer-sponsored health insurance that duplicates benefits covered by the Medicare for All Program would cease to exist by the passage of the legislation.
Medicare for All would fundamentally change how Americans obtain and pay for healthcare. This would be far more than an expansion of health insurance for the uninsured. Comprehensive private insurance plans would be replaced by the Medicare for All Program. For the uninsured, that could be a substantial improvement. But, for Americans satisfied with their existing coverage, it would mean surrendering their current insurance arrangements, whether they want to or not.
So, in essence, to supply health insurance to the small number of uninsured people in the country — just 7.9% of Americans in 2025 — the vast majority of currently insured people would have to give up their current health insurance. While we all want to see everyone insured, I am not sure that people fully understand what they are giving up. Medicare for All is, by its very nature, a redistribution-of-wealth program. Except, in this instance, it is redistributing your health insurance plan to people who don’t currently have health insurance and, in the process, making the health insurance offered to all far less desirable.
With Sen. Bernie Sanders’ Medicare for All Act now before Congress, it is very important that people understand what our representatives are voting for. They may well be voting to give up your health insurance.
Before Washington promises health insurance for everyone, Americans deserve a straight answer about whether they can keep the insurance they already chose.
Reader reactions, pro or con, are welcomed at civiltalk@iniusa.org.
