The following is not about Medicare for All, but simply extending the current Medicare coverage down to age 60. Note the increased federal deficit. And especially note the transfer of costs to the federal government outlined in red.
When you hear that M4A will pay for itself based on lower spending and efficiencies for the Country as a whole, the flaw in that argument is that the savings are not generated for government.
CBO and JCT estimate that lowering the age of Medicare eligibility to 60 would increase federal budget deficits by $155 billion over the 2026–2031 period through the effects of that policy on federal revenues and mandatory spending.
Enacting the policy would have a significant effect on primary sources of health insurance coverage, and it would increase the number of people insured. According to CBO’s estimate, in 2031:
Mandatory, or direct, spending includes outlays for some federal benefit programs and for certain other payments to people, businesses, nonprofit institutions, and state and local governments. Such outlays are generally governed by statutory criteria and are not normally constrained by the annual appropriation process.
• About 2.0 million fewer people would be enrolled in nongroup coverage, and almost all of them would enroll in Medicare instead.
• About 0.4 million fewer people would be without health insurance.
Those changes in health insurance coverage under the policy would cause federal deficits to increase for three main reasons:
• Although spending on health care would decrease, on average, for people with employment-based coverage under current law (largely because Medicare generally has lower payment rates for medical services), federal costs would increase because a larger share of that spending would be paid by the federal government rather than employers.
• Some people who are projected to be uninsured or enrolled in unsubsidized nongroup coverage under current law would instead have health insurance coverage subsidized by the federal government.
• Federal costs for people with Medicaid coverage under current law would increase, primarily because of greater spending on health care for people dually eligible for Medicaid and Medicare and because a greater share of those costs would be paid for by the federal government rather than state governments. Those costs would be partially offset by reductions in Medicaid spending for people who would lose their eligibility for Medicaid under the policy.