New Medicare Proposal Would Preserve Private Employer Coverage

Representative Rosa DeLauro, a Connecticut Democrat, has introduced the “Medicare for America Act,” a plan that would expand Medicare to all U.S. residents while still allowing people to keep qualifying employer-sponsored insurance.

In a press release, DeLauro said the proposal would do away with deductibles, cap premiums at 8 percent of income, and limit annual out-of-pocket costs to $3,500 for an individual and $5,000 for a household.

The measure appears to have little immediate chance of advancing: it has no cosponsors and would need to move through a Republican-controlled Congress.

According to the U.S. Census Bureau, about 26.7 million Americans, or 7.9 percent, were uninsured throughout 2025. Employer-based coverage remained the nation’s most common insurance source, covering 53.5 percent of the population for at least part of the year.

The lapse of enhanced Affordable Care Act subsidies has also raised costs for marketplace enrollees. KFF estimated that the expiration of those subsidies would increase average annual premiums for subsidized marketplace customers from $888 in 2025 to $1,904 in 2026, a 114 percent jump.

DeLauro first unveiled a version of Medicare for America in 2018.

Newsweek sought comment from DeLauro by email.

How the Plan Would Work

Unlike a single-payer model that would replace most private insurance, DeLauro’s proposal is structured around consumer choice.

All U.S. residents would be eligible for Medicare for America, and people without insurance would be enrolled automatically. Workers offered employer coverage could keep that plan or switch to the new Medicare option. If they chose Medicare for America, the employer would still have to contribute toward the premium.

Employers could also use Medicare for America to cover their workers. Private plans that remained in place would have to meet tougher standards, including dental, vision and hearing benefits.

That approach differs from the Medicare for All Act introduced by Representative Pramila Jayapal, a Washington Democrat, which would create a national Medicare-for-All system and bar duplicative coverage.

What Patients Would Pay

The plan would eliminate deductibles and cap premiums at 8 percent of household income. People earning less than 200 percent of the federal poverty level would pay no premiums or out-of-pocket costs.

Annual out-of-pocket spending would be capped at $3,500 for an individual and $5,000 for a household, with lower limits for families earning below 600 percent of the poverty level.

Coverage would include dental, vision and hearing care, prescription drugs, maternity and reproductive services, mental-health and substance-use treatment, and home- and community-based long-term care. Cost-sharing would be removed for preventive and emergency care, chronic disease management and care for children under 21.

The proposal would also ban prior authorization and step therapy and eliminate the 24-month Medicare waiting period for people with disabilities.

How DeLauro Wants to Control Costs

The bill would go beyond insurance coverage and try to reshape how medical care is priced.

Providers would have to accept Medicare for America rates from employer and Medicare Advantage plans under an all-payer rate-setting system. Payments for primary care and mental-health services would rise by at least 30 percent, while the legislation would also create site-neutral payments and aim to reduce Medicare Advantage overpayments.

Drug pricing would be overhauled as well. The health secretary would have to negotiate prices for all covered medications, and competitive licensing would be available if manufacturers rejected what the bill defined as a fair price.

How the Bill Would Be Paid For

DeLauro said the program would be financed in part by repealing the One Big Beautiful Bill Act, which made major spending cuts and policy changes across immigration, health care and social programs, along with new taxes on high earners, including a 5 percent surtax on income above $500,000.

She said the aim was to guarantee coverage without stripping people of the choices they already have.

“If you like your current employer coverage, you keep it,” DeLauro said when announcing the bill. “If you want Medicare, it is yours.”

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Could It Actually Pass?

For now, the proposal faces major political headwinds.

H.R. 10924 was introduced and sent to six House committees, including Ways and Means and Energy and Commerce. Congressional tracking currently lists DeLauro as the sole sponsor, with no cosponsors.

Republicans control both chambers of Congress, with 219 Republicans in the House and 53 Republican senators. That gives GOP leaders effective control over whether a broad Democratic health-care overhaul moves forward, making passage in the remaining weeks of the 119th Congress unlikely without a significant bipartisan shift.

There is much stronger Democratic support for another universal-coverage proposal already before Congress. Jayapal’s Medicare for All Act, H.R. 3069, has 118 Democratic cosponsors and no Republican cosponsors, according to congressional tracking data.

Other health measures moving through this Congress take narrower approaches. They include the bipartisan INSULIN Act of 2026, which would cap insulin costs, and a bill introduced in October that would lower Medicare eligibility to age 50.