Medicare for America Act Introduced by Rep. Rosa DeLauro

Representative Rosa DeLauro, a Democrat from Connecticut, has put forward the “Medicare for America Act.” This legislation would expand Medicare access to all residents while allowing them to keep employer-sponsored insurance if they choose. According to DeLauro’s press release, the act aims to eliminate deductibles and set premium caps at eight percent of individual income. It also proposes limiting out-of-pocket spending to $3,500 for individuals and $5,000 for households.

Currently, the act faces significant challenges as it has no cosponsors and must pass through a Republican-controlled Congress. Data from the U.S. Census Bureau shows 26.7 million Americans, or 7.9 percent, were uninsured throughout 2025. Employment-based insurance was the predominant form of coverage, encompassing 53.5 percent of people for part of the year. With the expiration of enhanced Affordable Care Act subsidies, costs for marketplace customers have risen. KFF estimates these expirations could increase annual premium payments for subsidized enrollees from $888 in 2025 to $1,904 in 2026.

How the Plan Would Work

DeLauro’s proposal centers on offering choices rather than adopting a single-payer system that would replace private insurance. Every U.S. resident would be eligible for Medicare for America. Those without insurance would be automatically enrolled. Employers would continue their contributions if employees opted for Medicare for America over existing insurance. Private plans would need to meet stricter requirements, including offering dental, vision, and hearing benefits.

This distinguishes it from Representative Pramila Jayapal’s Medicare for All Act, which proposes a national Medicare-for-All program and disallows duplicate coverage.

What Patients Would Pay

The Medicare for America plan would feature no deductibles and would limit premiums to 8 percent of household income. Households earning below 200 percent of the federal poverty level would not pay premiums or out-of-pocket costs. Limits for annual out-of-pocket spending would be $3,500 for individuals and $5,000 for households, with more lenient limits for families under 600 percent of the poverty level. Coverage includes dental, vision, hearing, prescription drugs, maternity, reproductive care, mental health, substance-use treatment, and long-term services.

Preventive care, emergency care, chronic disease management, and care for children under 21 would involve no cost-sharing. The act also removes the 24-month Medicare waiting period for people with disabilities and blocks prior authorization and step therapy.

Controlling Healthcare Costs

The legislation aims to reform health care pricing beyond mere insurance coverage. Providers would need to accept Medicare for America rates under an all-payer rate-setting framework. Payments for primary care and mental health services would increase by at least 30 percent. It plans to introduce unbiased site payments and reduce Medicare Advantage program overpayments. Drug pricing would undergo reforms, requiring the health secretary to negotiate medication prices. Competitive licensing would apply when manufacturers reject fair pricing according to the act.

Funding the Bill

To finance the program, DeLauro suggests repealing the One Big Beautiful Bill Act that reduced spending across several sectors. Additionally, new taxes on high earners, such as a 5 percent surtax on income above $500,000, are proposed. Her goal is to provide coverage without eliminating existing options. “If you like your current employer coverage, you keep it,” DeLauro stated in announcing the proposal.

Legislative Challenges

The proposal, filed as H.R. 10924 on October 29, has been assigned to six House committees, including Ways and Means and Energy and Commerce. At present, DeLauro is its sole sponsor with no cosponsors. Republicans, holding the majority with 219 members in the House and 53 senators, control whether the proposal advances, making its passage unlikely without bipartisan support.

In contrast, Jayapal’s Medicare for All Act, H.R. 3069, has 118 Democratic cosponsors. Other health bills in this Congress, such as the INSULIN Act of 2026, focusing on insulin costs, take a more targeted approach. Another recent measure proposes lowering Medicare eligibility to age 50.

This article was developed using Martyn, an AI assistant, and can be discussed further with editors Ben Kelly and Anthony Murray.