Plans for health care payment reform

Health Care For All Minnesota advocates universal, affordable, comprehensive, high quality healthcare for every Minnesotan. We favor the following legislative solutions that accomplish that goal.


In the Minnesota Legislature: 2021 Session

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HCA-MN is focused on health care payment reform in Minnesota, but we also track federal legislation.

In the United States Senate

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In the United States House of Representatives

(This section updated by Don Pylkkanen, as of 03/31/2021)

Medicare-for-All Act, HR 1976 (new bill number)  

Sponsor: Rep. Pramila Jayapal (Democrat, WA)

Re-filed: March 17, 2021 with a record 112 original co-sponsors

Minnesota Sponsors:

U.S. Rep. Ilhan Omar, CD 5   Co-sponsor date March 17, 2021

U.S Rep. Betty McCollum, CD 4  Co-sponsor date May 13, 2021  Congressional Record Statement

Co-Sponsors: Now at 115

Referred to: Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, Education and Labor, Rules, Oversight and Reform, Armed Services, and the Judiciary, for a period to be subsequently determined by the Speaker.

Has the main components of a single-payer system:

  1. one payer pays providers directly,
  2. contains costs by prohibiting commercial ACOs, HMOs, and other forms of insurance companies,
  1. a uniform fee schedule for doctors,
  2. annual individual budgets for hospitals, clinics, and nursing homes, and
  3. price limits on drugs and equipment.

Saves money by:

  1. paying hospitals and other medical providers lump sum global operating budgets to provide covered items and services;
  2. funding capital expenditures such as expansions and renovations with a separate budget;
  3. paying individual providers on a fee-for-service basis that does not include “value-based” payment adjustments (which is a form of insurance);
  4. prohibiting providers from using fees for profit, marketing, or bonuses;
  5. Department of Health and Human Services negotiating prices for drugs supplies, and equipment on an annual basis;
  6. establishing a national drug formulary that promotes the use of generics;
  7. allowing the override of drug patents when drug firms demand extortionate prices.

Total savings would be more than $600 billion annually by slashing the administrative waste of private insurance and the paperwork insurers impose on hospitals and doctors ($504 billion) and bargaining down drug prices ($155 billion).

These efficiencies would free up enough money for universal, first-dollar coverage without any overall increase in U.S. health spending, while controlling its growth over time.

Currently, the U.S. spends $3.65 trillion per year on health care, double the per-capita spending of other industrialized nations that provide universal coverage. Without single-payer reform, U.S. health spending is projected to reach $5.96 trillion– 19.4 percent of GDP- by 2027.

“Even single-payer opponents admit that, compared to Medicare for All, the status quo will cost the U.S. $2 trillion more over the next decade,” said Dr. Claudia Fegan, a Chicago-based internal medicine physician and PNHP national coordinator. “How do they propose we pay for that?”