Conyers Reintroduces “Expanded & Improved Medicare For All” Bill (HR 676)

Citing Rising Health Care Costs & Other Systemic Problems With For Profit Health Care As Reason To Move Forward With Non-Profit, Publicly-Financed Health Care

Download HR 676 here (.pdf). Download a summary of HR 676 here (.doc). See the full list of Congressional cosponsors here.

Washington DC- Representative John Conyers, Jr. (D-Mich.), a long-time national leader for non-profit publicly-financed universal health care, today introduced H.R. 676, “The Expanded & Improved Medicare For All Act.” The single-payer universal health care bill, which has been introduced since 2003, has 25 original cosponsors, and has sparked a growing national movement in support of the bill. The bill had 85 cosponsors in the 111th Congress, and has the support of over 17,000 doctors, nurses, organized labor, and many activists across the country.

“I am so pleased to announce that we have reintroduced H.R. 676, ‘The Improved and Expanded Medicare For All Act’ in the 112th Congress with 25 original cosponsors,” said Conyers. “The bill is almost identical to the single payer universal health care bill we introduced in the 111th Congress, but we have expanded the benefits package to include coverage of medically necessary oral surgery, nutritional, and dietary health care services, said Conyers.

“President Obama and the Democratic Congress passed historic health reform last year. To his credit, President Obama stated in his 2011 State of the Union Address that he is open to making changes to the law, so that it can be improved and strengthened. This presents a unique opportunity for supporters of improved Medicare For All to come together and work in a constructive way towards transitioning our for-profit and costly health care system to a high-quality, simple, and cost-effective improved Medicare For All program.

“Millions of Americans are frustrated with rising health care costs, and have a deep mistrust of private health insurance companies. The for-profit medicine model has resulted in rationed care and created undue stress and financial hardships for millions of Americans across the nation. Americans are smart—they know improved Medicare For all works in other countries. They also know that our own Medicare program, although not perfect, is a proven and efficient method for providing health care to America’s seniors.

“Perhaps this is why states like Vermont and California are very serious about transitioning towards publicly-financed universal health care programs. The Vermont State Legislature, with the full backing of Governor Peter Shumlin, will most likely pass the nation’s first ever state-based publicly-financed single-payer program sometime this year. This is a very exciting development for the universal health care movement, because success in Vermont could pave the way for the creation of improved Medicare For All programs in other states, and ultimately provide for the passage of H.R. 676.

“Improved and Expanded Medicare For All is inevitable in America– it is just a matter of when it will happen. Single-payer health care systems have successfully contained health care costs and provided high quality health care in countries in Europe, Taiwan, Japan, and Canada. We can no longer continue to embrace the idea that private insurance companies and corporate-owned hospitals and clinics will bring down the costs of health care on their own.

“It is time for Congress, other elected officials, the medical community, health care policy experts, and the national media to begin to seriously examine how a Medicare For All program in America could contain growing health care costs, and provide quality and affordable health care for all. Our current health care system is simply not financially sustainable over the long run. The time has come for deep systemic change in our health care system, and a large dose of common sense.”


  1. Christine Adams, Ph.D. on February 14, 2011 at 2:41 pm

    Estimate your savings under HR 676 with Health Care for All Texas’ healthcare calculator. Modeled after Loan amortization calculators, it will estimate some of the costs for single-payer and let’s you compare benefits proposed under HR 676 with what benefits and costs you have now. We can only estimate based on the the funding mechanism as proposed by HR 676. When national health insurance is passed, there may be a different funding scheme. However, we all know single-payer will cost less and give us better, quality health care guaranteed for life. Play around with the health care calculator to compare costs and benefits. Even with higher “health care payroll” or income taxes, single-payer will be less expensive and more sensible than our current employer-based for-profit health system: Check it out:

  2. John Barker on February 15, 2011 at 2:12 pm

    While any effort to help is welcome, Americans should not need a calculator. We have Medicare. The facts and figures are there for all to see. If Americans aren’t convinced of Medicare’s merits, can’t separate fact from fiction and vote against their own best interests then they have to pay the consequences.

  3. beowulf on February 16, 2011 at 2:01 am

    Basically Medicare for All required an additional $1 trillion annually in revenue. This could be done without raising tax rates: uncap SS FICA and allocate to Medicare trust fund ($200 bill), apply 15.3% FICA rate to all unearned income ($400 bill). Tax unrealized gains at FICA rate, liquid assets taxed annually mark to market like futures contracts and illiquid assets taxed retrospectively (with a tax penalty for each year of deferred taxation) like passive foreign investment companies. To ballpark it, $250 billion (triple what capital gains taxes collect now). Add carbon tax ($70 billion first year, growing thereafter) and securities transaction tax (at least $150 billion). For good measure, adopt Levy Institute iteration of Warren Buffett import certificate proposal, tariff auctions would raise 2% of GDP ($290 billion) and, as an added bonus, eliminate most of trade deficit.

    Oops, we’re $365 billion over and the out years for carbon and securities taxes would put us even further over. Use any excess revenue (or Medicare cost savings) to cut FICA taxes. At, say, $111 billion a point, it’d be a 3.3 point reduction. Use the “.3” to add Jacob Hacker’s “Universal Risk Insurance” to SS, so a 12.3% FICA rate with an expanded tax base would fund both an improved Social Security and Medicare for All. Of course, I’m overthinking this. As Brother Cheney so wisely put it, “Reagan taught us deficits don’t matter”. we could fund Medicare for All without touching the tax code– just throw in a “double blank check” clause like the one that funds student loans:
    “there is authorized to be appropriated, and there are appropriated, out of any money in the Treasury not otherwise appropriated, such sums as may be necessary for the purpose of carrying out section 1072 (c)(7) of this title.”

    • ter badger on February 24, 2011 at 12:27 pm


      You sound very knowledgeable, are those numbers real? i hope so and hope that you will forward your proposal to those who might use it to further the cause.

      • beowulf on February 28, 2011 at 5:14 am

        Ter badger,

        Thanks for your kind words. Not real in that they’re counterfactual to current law, but numbers are taken from analysis done by others. For example the securities transaction tax estimate is from work by economist Dean Baker and the carbon tax estimate is from a “Dear Colleague” letter by former Congressman Bob Inglis (a SC Republican who’s a good guy, naturally he lost in the primary to a tea party challenger last year). The “unrealized capital gains tax” revenue was a conservative estimate derived from work (of all people) by Mr. supply sider Arthur Laffer, who includes accrued gains in his “flat tax” proposal. Curiously, many people think unrealized capital gains aren’t taxable but as I noted above, they already are in at least two cases.

        Just for reasons of length, I left out other “green tax shift” measures (pollution, water, etc), the many “shelf project” proposals of tax professor Calvin H. Johnson (google him) and ceasing issuance of any Treasury debt longer than 3 months and capping short-term interest rates at 0.375% (as they were during World War II). Since CBO estimates (using a 5.0% avg. interest rate) $5 trillion in debt service over the next decade, that would cut spending by over $4.5 trillion, I can’t imagine what a better use of that money would be. :o)

        • Rodger Malcolm Mitchell on June 17, 2013 at 9:33 am


          Eliminate FICA. Provide Medicare for all. The U.S. government is Monetarily Sovereign. You know that.

    • D on January 30, 2012 at 3:29 pm

      Definitely one of the worst tax and spend ideas I’ve seen in a long time. Another example of shifting the expense / tax burden to the upper 50%, while most of the benefits go to the lower. Hard work and success should be rewarded. Greatly increasing taxes like this would cause a recession far worse than the one we’re experiencing. This has occupy wall street written all over it. Get a real job and let’s see how you feel.

  4. Margery Hanson on February 24, 2011 at 11:28 am

    I’ve been waiting for Single Payer since I was 9 and I’m 50 now … it’s the only way to go for every one =)

  5. Vic Anderson on February 24, 2011 at 12:47 pm

    Now, with No CHANCE of passage, Conyas resumes the DEM Wall Street-theatre!

  6. Ashley on February 24, 2011 at 12:49 pm

    Find a way to convince the Tea Party folks that this is “less government” and “reduce costs.” Unfortunately it’s hard to fit into a sound bite. But we HAVE to do something–the state of healthcare in this country is totally unacceptable.

    • beowulf on March 7, 2011 at 6:42 am

      Obamacare = corporate welfare

      Private insurers “add value” in only one way. As a govt program, Medicare can’t make campaign contributions, private insurers are not so constrained.. That’s why Obamacare included half a trillion in premium subsidies with no limit placed on what premiums could cost.

      There’s no reason to mandate citizens pay taxes to private sector middlemen when the existing Medicare system already provides healthcare more cost-effectively than any private insurer. Campaigns will just have to be funded by someone else.

  7. Eric Ganguly on February 24, 2011 at 1:21 pm

    This is great we should continue to work towards a publicly-financed single-payer, yes im not afraid to say it healthcare system, it may take time but we will get there. By the way in the current healthcare law that President Obama signed, the individual mandate for thos without health insurance to purchase health insurance fails the test of liberty, not even the British forced us to buy tea.

  8. Beth Morey on February 24, 2011 at 4:20 pm

    Time for our elected officials to stop pandering to Big Money insurance and health care conglomerates… Do the right thing for the American people!

  9. Jennifer on February 24, 2011 at 4:24 pm

    Unless a requirement for all physicans with American Licensure to a participate in the program is added, this may not work. If doctors refuse to take Medicare for All patients, then where would we go? The must be required to accept it period. In Washington, DC where I am a healthcare professional, almost no doctors take Blue Cross or Carefirst in the affluent parts of the city and it is getting harder for Seniors to find physicans who will take Medicare patients. More and more doctors are closing their panels. Very few of the really good doctors even participate. It can be very frustrating for patients. Our practice ONLY particiaptes with Medicare…who knows for how long though..we are a general surgery practice.

    • tina on March 2, 2011 at 3:58 pm

      It’s good that you brought that up, Jennifer. A lot of people don’t realize that HR 676 would cover everyone, so all patients and potential patients would have it. Doctors who refuse to accept it would probably find very few patients, in any market. This would bring patients an added benefit–the ability to choose one’s own doctor–something that doesn’t truly exist under the current system.

  10. Jennifer on February 24, 2011 at 4:25 pm

    Unless a requirement for all physicans with American Licensure to a participate in the program is added, this may not work. If doctors refuse to take Medicare for all patients, then where would we go? The must be required to accept it period. In Washington, DC where I am a healthcare professional, almost no doctors take Blue Cross or Carefirst in the affluent parts of the city and it is getting harder for Seniors to find physicans who will take Medicare patients. More and more doctors are closing their panels. Very few of the really highest rated doctors even participate. It can be very frustrating for patients. Our practice ONLY participates with Medicare…who knows for how long though..we are a general surgery practice.

    • beowulf on March 7, 2011 at 6:51 am

      On the other hand, no one is against medical providers being paid a fair price for their work. The state to look at as a model is the one with the most generous safety net. I’m referring to that den of socialists, Alaska (OK, its 100% due to the state receiving more oil royalties than it knows what to do with).

      “Medicaid pay is based on a formula similar to that of Medicare. However, Alaska Medicaid reimburses physicians almost 50% more than Medicare, said Jim Jordan, executive director of the Alaska State Medical Assn.”

  11. Victoria on February 24, 2011 at 5:49 pm

    If all Americans have Medicare for all, physicians will have no patients if they refuse to accept this payment. The whole idea is to dispense with the high costs of the insurance companies: advertising costs, profits, multiple layers of bureaucracy, extra staff for physicians to sort out billing.
    To get a wheelchair cushion for my husband, we had to go through 4 entities: the doctor to prescribe it, the retailer to provide it, the insurance company to approve it, and another “cost-saving” company to make sure it was essential, to save the insurance company costs. These people all needed to be paid. Two of them were unnecessary – why does my doctor need double-checking by some bureaucrat?

  12. Dervish on February 24, 2011 at 9:43 pm

    Logically, we have no reason to continue to deny a public health plan for all Americans.

    Only the elderly, the very poor, the incarcerated, active military, and some poorer veterans have access to public health plans. In other words, only the most at-risk portions of the population.

    Apparently, we’re only allowed to socialize the loss. Everyone else in the US is the exclusive domain of the private health insurance industry. America needs to realize that we can’t afford NOT to provide the rest of the public with a single payer health care system.

  13. Dr. Parker on February 24, 2011 at 11:07 pm

    When a self-employed person like me has a bare bones (emergency only care) health insurance policy that costs more each month than my house payment, there is something VERY wrong with our National Health Care system. Health care should never be provided by “for profit” corporations. We don’t want “health insurance”, we want health care. I support HR 676 ! ! !

  14. David Greenstein on February 25, 2011 at 12:10 am

    I could not agree more. There are so many advantages of single payer Medicare for all that we have to over rule the congressional decisions based on insurance company bribes. Adding the the younger population with less healthcare needs would make Medicare more cost effective. I would add though that everyone should have a percentage responsibility when utilizing any health care services. Free services would have too little cost control. Requiring individuals to have even a small (progressive depending upon wealth) responsibility with ensure that necessary and not frivolous services will be used. Doctors and hospitals should also be required to publish price lists to ensure natural competitive controls.

  15. AlwaysAskWHY on February 25, 2011 at 1:31 am

    The greatest thanks for reintroducing this bill. I would like to offer a few thoughts (TALKING POINTS) for changing the way we talk about Health Care for All:



    2. Health Care for All – a national, not for profit, Single Payer system, like the very successful Medicare system, will lower health care costs across the board, taking the exorbitant insurance company overhead expenses out of the system. Medicare’s operating costs are, reportedly, about 3%, while private insurance companies’ operating costs (CEO salaries, stock, advertising, legal costs) are about 30%!

    3. Taking HEALTH CARE off of the back of business will give all businesses more money to invest, hire and innovate. Note: Many small business owners can’t even afford health care for their own families – and suffer emotionally watching their employees and their families suffer.

    4. MOBILITY: Workers will be able to work where want, not stay in unsatisfying or low paying jobs because they fear losing health care for themselves, their families or their elderly parents.

    5. American Employers will have healthier employees who WANT TO BE THERE, and it will REMOVE the acrimonious employer/employee relationship that is always stressed over health care expenses.

    6. Elderly workers, who want to or should be retiring, CAN – without fear of losing health care for themselves or a spouse who is ill.

    7. American Workers will be free to return to school and/or continue their education — which many don’t do out of fear of losing health care for themselves and their families.

    8. Our children can finish school without worrying about not having health care.


    Let’s change the dialog and TAKE BACK THE DEBATE.


  16. Dominic Jermano on February 25, 2011 at 5:45 am

    Why doesn’t anyone ever explain what single payer really means?

    • Dominic Jermano:

      I love your question. I would be glad to give you a set of straightforward materials to read. A team of us has projects recently to do reviews and refinements to documents that do better than ever before on addressing your concern. Contact me so that I know that you saw this. Then I’ll take the time to compose the reply for you and also post it here at the website.

      Bob the Health and Health Care Advocate bob[at]medicareforall[dot]org

    • Katie on March 1, 2011 at 9:36 am

      You can find more info on single-payer here!

  17. Charity Moschpoulos on February 25, 2011 at 10:28 am

    WOW!!! Let’s go for it!!

    • Chuck T on February 25, 2011 at 1:13 pm

      Unfortunately being that this would help the lower and middle class, republicans will keep up with the lies as they do not want to loose the money they get from all of the insurance companies. I am so sick of their lies and wish the American voters would wise up and vote all of them out. There only objective is to get elected. They do not care about anything except making money and lowering taxes for their contributors, the wealthy and corporations. Wake up America.

  18. raquel brac on February 25, 2011 at 12:55 pm

    I do not understand how this will help since the congress is ruled by republicans who will not allow this to go forward. I am tired of fighting for something that did not have a chance even when democrats were in the majority and over 60% of the nation wanted it. I need to save my strength for something that may work, for example, helping democratically run states to implement single payer.This is what we should be concentrating on. Showing governors how cost effective this would be in these budget-crunching times.

  19. Emilio on February 26, 2011 at 8:06 am

    Conyers is just another misleading politician whose only aim is the furtherance of his career. This yahoo promised prosecution of the Bush criminals during his days in the minority, yet when the Democrats took back the House in 2006 he went AWOL. Disingenuous people like Conyers are the death knell of democracy, and nothing he says or does has any weight.

  20. Pete Altomare on February 27, 2011 at 10:52 pm

    Yeah, now Boehner is Speaker, now this surfaces again.
    No chance of even getting out of Committee, so the progressive caucus flogs it again.
    Where was the Progressive Caucus in 2009-2010?