Memo Published February 12, 2026 · 4 minute read
Read This Before Supporting Medicare for All
David Kendall
The perennial push for Medicare for All is back, and the timing couldn’t be worse. Republicans are on the ropes over their unpopular cuts to Obamacare and Medicaid. President Trump’s serial federal overreach along with RFK Jr’s commandeering of health norms has awakened the nation to the damage a president with unchecked ambitions can do with our health care.
A turn toward single payer would save staggering Republicans at the bell. It would hand the GOP a gift: a clear, credible attack line that Democrats want to replace health care in this country with a government-run system. That’s not political spin—it’s a fact. Section 107 of Medicare for All would outlaw all existing private coverage and force everyone onto a government plan. That’s not what Americans want. What they want is lower costs, fewer headaches, and stronger protections.
A better plan for Democrats is to deliver lower costs, universal coverage, an end to price gouging, and more health care protections through the popular Affordable Care Act. Still, the pressure from organizations to get Democrats to sign on to Medicare for All will be intense. Here are seven reasons to resist.
1. Trump and RFK Jr. would decide what health care you get. Medicare for All puts the government fully in charge of health care. That may be fine under Democratic administrations, but think of what it would mean during Republican ones: no coverage for abortion, contraception, and childhood vaccines. Science-based public health would disappear, and care would continue to be cut. Don’t think that could happen? You’re kidding yourself.
2. It costs an astronomical amount. Over 10 years, the federal cost would be $44 trillion according to estimates updated for inflation. All federal taxes on families and businesses would have to double to afford it.
3. Providers would game the system. As proposed, Medicare for All would cut providers’ pay by 40% below what they currently receive from private health plans. That will never happen because hospitals would go broke, doctors and nurses would have their pay cut, and lobbying pressure from hospitals, physicians, pharmaceutical companies, and all other providers would win the day. They would also bill for more services to game the reimbursement system.
4. Everyone would lose their current coverage. Medicare for All would cause massive disruption in coverage. Nearly everyone would have to change coverage, including the 183 million with private coverage, 68 million with Medicaid coverage, and 34 million with Medicare Advantage. Even people with traditional fee-for-service, which is the basis of Medicare for All, would lose their retiree coverage and Medi-gap supplemental coverage.
5. Medicare for All has failed time and time again. Over many decades, single payer has failed in the legislature and on the ballot. Vermont passed single payer but had to abandon it because of costs and its tax impact on families. Colorado voters rejected it by a margin of 58 points (79% to 21%). California’s single-payer Proposition 186 had just 26.6%. Oregon’s single-payer ballot measure only got 21.5% of the vote.
6. Medicare for All has a glass jaw. Medicare for All is popular until opponents bring up the downsides—it eliminates private insurance (support drops from 56% to 37%), requires most Americans to pay more in taxes (support drops to 37%), threatens Medicare (support drops to 32%), and leads to delays in tests and treatments (support drops to 26%).
7. We throw away our health care advantage. By pressing Democrats’ advantage on health care, many gains are possible beyond reversing the damage caused by Republicans. The Affordable Care Act is popular and provides a strong foundation on which to build. Democrats can expand the ACA with a Health Care Bill of Rights to end medical debt, stop price gouging, get everyone enrolled in coverage, and make health care simpler and more accessible.
