Medicare for All

On July 30th, 2025 Medicare and Medicaid celebrated their 60^th birthdays. These groundbreaking programs became life-saving and poverty-reducing benefits for seniors, the disabled, and many within the working class. When coupled with other public or subsidized programs, including Veterans Administration (VA) benefits, State Children’s Health Insurance Program (SCHIP), and the Affordable Care Act (ACA) exchanges, these programs improved life expectancy, broadened health access, lowered costs, and drove down the U.S. uninsured rate to an all-time low of 7.9 percent in 2023.

However, the work of decades is now being unwound. Despite earlier promises to the contrary by President Trump, his “One Big Beautiful Bill Act” (OBBB) contained $911 billion in cuts to Medicaid. The Act creates new, more onerous paperwork for low-income recipients, with the presumption that eligible recipients will be kicked off insurance. It also cuts direct and indirect funding to states, forcing them to choose between steep new taxes or immediate Medicaid cuts. These cuts will also result in the closure of rural hospitals, as well as a reduction of services provided by the hospitals that remain open. Already a rural hospital in Nebraska has announced its closure due to the changes, with at least 300 more rural hospitals nationwide in immediate risk of closure (UNC Sheps Center report).

Less well known, the OBBB didn’t leave Medicare untouched. New rules which would have made Medicare premiums affordable for low-income enrollees have been postponed to 2034. The Act also cut off access to Medicare for many documented immigrants and restricts the ability of Medicare to negotiate drug prices. Perhaps worst, absent further congressional action $490 billion in Medicare cuts start in 2027.

At the same time, the Biden-era expansions of the ACA subsidies expires at the end of 2025. Without further legislative action, the Kaiser Family Foundation estimates ACA premiums will rise by as much as 75 percent. When taking this into account, along with the Medicaid and Medicare cuts, 16 million more people may lack health insurance by 2034, with the percent of American residents without insurance potentially higher than before the ACA was passed.

Cuts these deep will cost lives. According to a study by the Leonard Davis Institute of Health Economics, at least 42,500 additional people will die annually due to these policy changes, through a mixture of losing health coverage, losing access to prescription drug benefits, and elimination of a Biden-era rule on staffing of nursing homes. All of this, just to help pay for a $1 trillion tax break to billionaires and corporate fatcats.

The U.S. healthcare system is not designed to protect the health of Americans. Instead, it is designed to accumulate as much profit as possible for private businesses. From 2000 to 2023 the average pharmaceutical company had a profit margin of nearly 14 percent—almost twice that of the median Fortune 500 company. For-profit hospitals and other providers have every incentive to set fees as high as possible. Insurers keep their own costs low through denial of care. Both sides war with one another, setting up huge bureaucracies to adjudicate claims, and pushing through waves of corporate consolidation to try and outgrow the other. American workers are caught in the crossfire, with none of these groups looking out for our interests.

Our dysfunctional healthcare system leaves Americans drowning in medical debt. An investigation by the Kaiser Family Foundation found over 100 million people in America struggle with medical debt, including 41 percent of all adults. They also found that, in the last five years, more than half of U.S. adults have gone into debt because of dental or medical bills. About one in five of those in medical debt reported that they didn’t expect to ever pay their debt off. About two thirds of those in medical debt have reported that they have delayed care for themselves or a family member because of cost. In 2025, 36 percent of all Americans reported they had to delay medical treatments due to cost, including 75 percent of the uninsured. Medical debt is the leading cause of bankruptcy, accounting for 66.5 percent of all bankruptcies in the U.S.

The patchwork system of U.S. health insurance is unsustainable, even as a reactionary assault against it continues. The U.S. is the only Organization for Economic Co-operation and Development (OECD) country not to guarantee healthcare to all as a fundamental human right. The U.S. system costs twice as much per capita as that of other OECD nations. The Centers for Medicare and Medicaid Services reports that the U.S. spends $14,570 per capita on healthcare. In contrast the United Kingdom spends $6,023 per capita, and Canada spends $7,013. Yet, these countries that spend half as much–and many others–gauarantee healthcare to all and achieve better health outcomes.

The health inequities of the U.S. healthcare system are felt the most by people of color. Members of racial and ethnic minority groups disproportionately suffer from inequitable health insurance coverage and higher rates of medical debt. These racial groups experience higher rates of illness and death across a wide range of health conditions, including heart disease, cancer, diabetes, and hypertension.

Fortunately, Senator Bernie Sanders and Representative Pramila Jayapal have introduced the Medicare For All Act of 2025 to the House (H.R. 3069) and Senate (S. 1506). The Medicare For All Act would provide universally guaranteed healthcare coverage to all; eliminate co-pays, deductibles, and premiums; eliminate the racial disparities in healthcare coverage; provide reproductive healthcare and gender-affirming care; allow unions to negotiate higher pay and benefits; reduce our healthcare costs; eliminate medical debt; reduce preventable death; and make our healthcare system about health instead of about profit.

Thanks to the efforts of the labor movement and other activists, 15 senators and 105 house members have already re-endorsed the Medicare for All Act. However, it will take a mass movement of workers applying pressure at every level of government to win it. We must continue to organize and educate, to ensure when an opening for health care legislation arrives once again, it’s not a half-measure like the ACA, but full, universal healthcare for all.

THEREFORE, BE IT RESOLVED THAT THIS 79^th UE CONVENTION:

1. Demands Congress:
   1. Enact the Medicare for All Act and in the meantime expand Medicare to include full coverage of dental, vision, and hearing, negotiation of drug prices, and lowering of the age of eligibility;
   2. Reverse all recent spending cuts to Medicare and Medicaid, extend the ACA enhanced subsidies, and pass legislation halting the Trump Administration’s efforts to gut Veterans’ Administration (VA) healthcare provision;
2. Supports efforts to institute single-payer programs at the state level;
3. Encourages locals and regions make use of UE’s “How to Fix Healthcare” workshop and to follow the action steps outlined in the workshop, including:
4. Use UE’s Healthcare Cost Calculator, especially during contract negotiations;
5. Educate members about the real cost of their existing healthcare and organize members to call and visit their congresspeople in support of Medicare for All;
6. Collaborate with their employer on a mutually-agreed-upon public statement in support of Medicare for All;
7. Urges locals to designate or elect at least one member to be a UE Medicare for All activist who would share Medicare for All information with the members;
8. Opposes all further efforts to undermine and/or privatize the Affordable Care Act, Medicare, Medicaid, Indian Health Service, and VA health benefits;
9. Encourages the union at all levels to participate in coalitions for universal healthcare, including Labor Campaign for Single Payer, Physicians for a National Healthcare Program (PNHP), and Healthcare NOW!;
10. Urges locals to contact their local VA to learn what medical benefits are available to our veteran members, and to lobby for restoration of fully-funded medical benefits for veterans and their families;
11. Encourages locals to support the growing campaign for paid sick days and family leave in cities and states across the country;
12. Calls upon the local, state and federal governments to expand coverage for mental health and substance abuse issues.