Summary: We estimate the budgetary, economic, health and health coverage effects the Medicare for All Act of 2019 (S.1129) introduced by Senator Sanders, which would provide universal coverage, eliminate all private and public health insurance programs, and expand Medicare to cover additional benefits. More information on the specifics of the act can be found in our analysis of the estimate.

Table 1. Effects of Medicare for All on Health Outcomes

Financing Mechanism

Initial Drop in Total Health Expenditures

Increase in Home and Community-Based Services

Overhead Costs

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Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 3%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.8	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.0	-1.2	-12.0

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 5%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.0	-1.2	-12.0

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 3%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.0	-1.2	-12.0

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 1%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.0	-1.2	-12.0

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 5%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.3	-12.0

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 3%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.3	-12.0

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 1%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.3	-12.0

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 5%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.3	-12.0

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 3%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.3	-12.0

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 1%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.3	-12.0

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 5%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.8	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.0	-1.2	-12.0

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 3%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.8	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.0	-1.2	-12.0

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 1%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.8	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.0	-1.2	-12.0

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 5%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.3	-12.0

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 3%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.3	-12.0

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 1%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.3	-12.0

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 5%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.8	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.2	-12.0

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 3%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.2	-12.0

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 1%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.3	-12.0

The excess debt buildup for this simulation prevented a solution with forward-looking capital markets.

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 5%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	.	.	.	.
2040	.	.	.	.
2050	.	.	.	.
2060	.	.	.	.

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 3%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.8	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.0	-1.2	-12.0

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 1%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.8	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.0	-1.2	-12.0

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 5%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.2	-12.0

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 3%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.2	-12.0

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 1%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.2	-12.0

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 5%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.8	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.2	-12.0

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 3%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.8	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.2	-12.0

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 1%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.8	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.2	-12.0

The excess debt buildup for this simulation prevented a solution with forward-looking capital markets.

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 5%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	.	.	.	.
2040	.	.	.	.
2050	.	.	.	.
2060	.	.	.	.

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 3%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.0	-1.3	-12.0

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 1%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.0	-1.3	-12.0

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 5%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.8	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.2	-12.0

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 3%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.8	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.2	-12.0

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 1%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.8	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.2	-12.0

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 5%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.8	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.2	-12.0

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 3%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.8	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.2	-12.0

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 1%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.8	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.2	-12.0

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 5%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.0	-1.3	-12.0

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 3%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.0	-1.3	-12.0

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 1%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.0	-1.3	-12.0

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 5%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.3	-12.0

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 3%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.3	-12.0

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 1%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.3	-12.0

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 5%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.3	-12.0

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 3%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.3	-12.0

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 1%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.3	-12.0

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 5%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.0	-1.2	-12.0

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 3%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.0	-1.2	-12.0

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 1%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.0	-1.2	-12.0

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 5%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.3	-12.0

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 3%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.3	-12.0

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 1%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.3	-12.0

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 5%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.3	-12.0

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 3%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.3	-12.0

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 1%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.3	-12.0

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 5%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.8	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.0	-1.2	-12.0

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 3%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.8	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.0	-1.2	-12.0

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 1%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.8	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.0	-1.2	-12.0

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 5%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.2	-12.0

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 3%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.2	-12.0

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 1%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.2	-12.0

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 5%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.2	-12.0

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 3%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.2	-12.0

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 1%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.3	-12.0

The excess debt buildup for this simulation prevented a solution with forward-looking capital markets.

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 5%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	.	.	.	.
2040	.	.	.	.
2050	.	.	.	.
2060	.	.	.	.

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 3%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.8	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.0	-1.2	-12.0

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 1%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.8	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.0	-1.2	-12.0

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 5%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.8	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.2	-12.0

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 3%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.8	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.2	-12.0

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 1%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.8	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.2	-12.0

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 5%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.8	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.2	-12.0

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 3%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.2	-12.0

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 1%
Year	Longevity*	Population Size	Percent in Worst Health State**	Percent Forgoing Care**
2030	0.3	0.5	-0.9	-8.0
2040	0.8	1.4	-1.1	-10.4
2050	1.3	2.2	-1.2	-11.7
2060	1.8	3.1	-1.2	-12.0

Except where indicated, numbers represent a percent change relative to current law.
* The change in longevity is measured in years.
** Percentage point difference from current law.

Table 2. Effects of Medicare for All on Health Coverage

Financing Mechanism

Initial Drop in Total Health Expenditures

Increase in Home and Community-Based Services

Overhead Costs

Please view online or download the data to view additional scenarios.

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 3%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-7.3	-72.7	-8.0	-5.7
2040	-20.0	-12.2	-77.3	-5.6	-4.0
2050	-23.2	-16.6	-80.0	-1.9	-1.3
2060	-26.2	-17.0	-81.9	0.6	0.4

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 5%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-5.2	-72.7	-16.4	-11.5
2040	-20.0	-9.0	-77.3	-15.2	-10.7
2050	-23.2	-12.4	-80.0	-11.4	-8.1
2060	-26.2	-13.4	-81.9	-6.6	-4.7

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 3%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-5.0	-72.7	-17.8	-12.5
2040	-20.0	-8.6	-77.3	-16.7	-11.7
2050	-23.2	-12.1	-80.0	-12.9	-9.1
2060	-26.2	-13.2	-81.9	-8.2	-5.8

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 1%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-4.8	-72.7	-19.1	-13.5
2040	-20.0	-8.3	-77.3	-18.0	-12.7
2050	-23.2	-11.7	-80.0	-14.4	-10.1
2060	-26.2	-13.0	-81.9	-9.8	-6.9

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 5%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-2.0	-72.7	-16.1	-11.3
2040	-20.0	-3.6	-77.3	-14.9	-10.5
2050	-23.2	-5.8	-80.0	-11.2	-7.9
2060	-26.2	-7.8	-81.9	-6.5	-4.6

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 3%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-2.0	-72.7	-17.5	-12.3
2040	-20.0	-3.6	-77.3	-16.4	-11.5
2050	-23.2	-5.8	-80.0	-12.7	-9.0
2060	-26.2	-8.0	-81.9	-8.1	-5.7

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 1%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-1.9	-72.7	-18.9	-13.3
2040	-20.0	-3.5	-77.3	-17.8	-12.5
2050	-23.2	-5.8	-80.0	-14.2	-10.0
2060	-26.2	-8.1	-81.9	-9.6	-6.8

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 5%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-9.3	-0.5	-16.1	-11.3
2040	-20.0	-8.5	-7.8	-15.0	-10.5
2050	-23.2	-10.4	-10.2	-11.2	-7.9
2060	-26.2	-12.3	-9.2	-6.5	-4.6

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 3%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-8.6	-3.4	-17.5	-12.3
2040	-20.0	-8.4	-10.6	-16.4	-11.5
2050	-23.2	-9.9	-12.8	-12.8	-9.0
2060	-26.2	-12.0	-11.9	-8.1	-5.7

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 1%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-8.3	-6.3	-18.8	-13.3
2040	-20.0	-8.2	-13.3	-17.8	-12.5
2050	-23.2	-9.4	-15.4	-14.2	-10.0
2060	-26.2	-12.0	-14.6	-9.6	-6.8

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 5%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-6.8	-72.7	-12.6	-8.8
2040	-20.0	-11.5	-77.3	-11.2	-7.9
2050	-23.2	-15.7	-80.0	-7.7	-5.5
2060	-26.2	-16.0	-81.9	-4.2	-3.0

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 3%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-6.6	-72.7	-14.0	-9.8
2040	-20.0	-11.2	-77.3	-12.6	-8.9
2050	-23.2	-15.2	-80.0	-9.2	-6.5
2060	-26.2	-15.5	-81.9	-5.6	-4.0

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 1%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-6.1	-72.7	-15.3	-10.8
2040	-20.0	-10.6	-77.3	-14.0	-9.9
2050	-23.2	-14.5	-80.0	-10.6	-7.5
2060	-26.2	-14.9	-81.9	-7.1	-5.0

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 5%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-3.8	-72.7	-12.5	-8.8
2040	-20.0	-6.0	-77.3	-10.9	-7.7
2050	-23.2	-8.2	-80.0	-6.8	-4.8
2060	-26.2	-9.1	-81.9	-1.9	-1.3

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 3%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-4.0	-72.7	-13.9	-9.8
2040	-20.0	-6.2	-77.3	-12.3	-8.7
2050	-23.2	-8.5	-80.0	-8.3	-5.8
2060	-26.2	-9.6	-81.9	-3.4	-2.4

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 1%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-3.6	-72.7	-15.3	-10.7
2040	-20.0	-5.8	-77.3	-13.7	-9.6
2050	-23.2	-8.2	-80.0	-9.7	-6.8
2060	-26.2	-9.4	-81.9	-4.8	-3.4

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 5%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-10.3	1.8	-11.5	-8.1
2040	-20.0	-10.6	-5.9	-9.3	-6.6
2050	-23.2	-12.8	-8.5	-4.4	-3.1
2060	-26.2	-14.8	-7.7	1.8	1.2

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 3%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-9.4	-1.5	-13.0	-9.1
2040	-20.0	-9.3	-8.9	-10.8	-7.6
2050	-23.2	-11.4	-11.5	-6.0	-4.2
2060	-26.2	-13.7	-10.8	0.0	0.0

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 1%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-9.1	-4.5	-14.3	-10.1
2040	-20.0	-9.0	-11.8	-12.3	-8.6
2050	-23.2	-10.7	-14.5	-7.5	-5.3
2060	-26.2	-13.1	-13.8	-1.6	-1.1

The excess debt buildup for this simulation prevented a solution with forward-looking capital markets.

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 5%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	.	.	.	.	.
2040	.	.	.	.	.
2050	.	.	.	.	.
2060	.	.	.	.	.

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 3%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-9.8	-72.7	-2.2	-1.5
2040	-20.0	-15.3	-77.3	0.3	0.2
2050	-23.2	-21.4	-80.0	4.2	3.0
2060	-26.2	-22.7	-81.9	6.9	4.9

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 1%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-9.2	-72.7	-3.5	-2.5
2040	-20.0	-14.6	-77.3	-1.1	-0.8
2050	-23.2	-20.1	-80.0	2.7	1.9
2060	-26.2	-21.1	-81.9	5.2	3.7

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 5%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-6.2	-72.7	-1.1	-0.8
2040	-20.0	-9.0	-77.3	1.8	1.3
2050	-23.2	-11.6	-80.0	6.8	4.8
2060	-26.2	-12.0	-81.9	11.7	8.2

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 3%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-5.9	-72.7	-2.5	-1.7
2040	-20.0	-8.8	-77.3	0.4	0.3
2050	-23.2	-11.4	-80.0	5.4	3.8
2060	-26.2	-11.9	-81.9	10.2	7.2

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 1%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-5.8	-72.7	-3.8	-2.7
2040	-20.0	-8.7	-77.3	-0.9	-0.6
2050	-23.2	-11.2	-80.0	4.0	2.8
2060	-26.2	-11.7	-81.9	8.8	6.2

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 5%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-10.9	3.0	0.7	0.5
2040	-20.0	-12.1	-5.1	4.7	3.3
2050	-23.2	-14.3	-8.0	11.2	7.9
2060	-26.2	-15.7	-7.4	18.6	13.1

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 3%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-9.9	-0.3	-0.7	-0.5
2040	-20.0	-11.2	-8.1	3.2	2.2
2050	-23.2	-13.4	-11.0	9.6	6.8
2060	-26.2	-14.6	-10.3	16.8	11.8

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 1%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-9.1	-3.4	-2.1	-1.5
2040	-20.0	-10.0	-11.2	1.7	1.2
2050	-23.2	-12.4	-13.8	8.0	5.6
2060	-26.2	-13.9	-13.2	15.0	10.6

The excess debt buildup for this simulation prevented a solution with forward-looking capital markets.

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 5%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	.	.	.	.	.
2040	.	.	.	.	.
2050	.	.	.	.	.
2060	.	.	.	.	.

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 3%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-3.2	-72.7	4.7	3.3
2040	-20.0	-4.5	-77.3	7.0	4.9
2050	-23.2	-6.7	-80.0	10.1	7.1
2060	-26.2	-9.8	-81.9	11.3	8.0

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 1%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-3.0	-72.7	3.4	2.4
2040	-20.0	-4.4	-77.3	5.7	4.0
2050	-23.2	-6.7	-80.0	8.9	6.3
2060	-26.2	-9.8	-81.9	10.4	7.3

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 5%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-7.7	-72.7	6.6	4.7
2040	-20.0	-11.0	-77.3	10.3	7.2
2050	-23.2	-14.4	-80.0	15.5	11.0
2060	-26.2	-14.7	-81.9	20.0	14.1

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 3%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-7.5	-72.7	5.2	3.7
2040	-20.0	-10.8	-77.3	8.9	6.2
2050	-23.2	-14.1	-80.0	14.1	10.0
2060	-26.2	-14.4	-81.9	18.5	13.1

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 1%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-7.3	-72.7	3.9	2.8
2040	-20.0	-10.6	-77.3	7.6	5.3
2050	-23.2	-13.8	-80.0	12.8	9.0
2060	-26.2	-14.0	-81.9	17.1	12.1

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 5%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-12.4	2.7	8.9	6.3
2040	-20.0	-14.1	-5.5	13.9	9.8
2050	-23.2	-16.3	-8.4	21.1	14.9
2060	-26.2	-17.1	-7.6	28.6	20.2

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 3%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-11.4	0.7	7.4	5.2
2040	-20.0	-12.9	-7.4	12.4	8.7
2050	-23.2	-14.8	-10.3	19.5	13.8
2060	-26.2	-15.6	-9.5	26.9	19.0

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 1%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-10.3	-2.4	6.0	4.2
2040	-20.0	-11.8	-10.3	10.9	7.7
2050	-23.2	-14.1	-13.1	17.9	12.6
2060	-26.2	-15.1	-12.4	25.1	17.7

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 5%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-4.2	-72.7	-22.3	-15.7
2040	-20.0	-7.6	-77.3	-21.3	-15.0
2050	-23.2	-10.9	-80.0	-17.8	-12.5
2060	-26.2	-12.4	-81.9	-13.4	-9.4

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 3%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-4.1	-72.7	-23.6	-16.6
2040	-20.0	-7.4	-77.3	-22.6	-15.9
2050	-23.2	-10.7	-80.0	-19.2	-13.5
2060	-26.2	-12.3	-81.9	-14.8	-10.5

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 1%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-4.1	-72.7	-24.8	-17.5
2040	-20.0	-7.2	-77.3	-23.8	-16.8
2050	-23.2	-10.4	-80.0	-20.5	-14.4
2060	-26.2	-12.2	-81.9	-16.2	-11.5

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 5%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-1.7	-72.7	-22.0	-15.5
2040	-20.0	-3.5	-77.3	-21.0	-14.8
2050	-23.2	-5.9	-80.0	-17.6	-12.4
2060	-26.2	-8.3	-81.9	-13.2	-9.3

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 3%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-1.7	-72.7	-23.3	-16.4
2040	-20.0	-3.4	-77.3	-22.3	-15.7
2050	-23.2	-5.9	-80.0	-19.0	-13.4
2060	-26.2	-8.3	-81.9	-14.7	-10.4

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 1%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-1.6	-72.7	-24.5	-17.3
2040	-20.0	-3.3	-77.3	-23.6	-16.6
2050	-23.2	-5.8	-80.0	-20.3	-14.3
2060	-26.2	-8.3	-81.9	-16.1	-11.4

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 5%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-7.0	-12.9	-22.0	-15.5
2040	-20.0	-6.0	-19.6	-21.0	-14.8
2050	-23.2	-7.4	-21.7	-17.6	-12.4
2060	-26.2	-9.2	-20.8	-13.2	-9.3

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 3%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-6.3	-15.7	-23.3	-16.4
2040	-20.0	-5.3	-22.3	-22.3	-15.7
2050	-23.2	-6.6	-24.3	-19.0	-13.4
2060	-26.2	-8.3	-23.5	-14.7	-10.4

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 1%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-6.3	-18.3	-24.5	-17.3
2040	-20.0	-5.4	-24.8	-23.6	-16.6
2050	-23.2	-6.3	-26.8	-20.3	-14.3
2060	-26.2	-8.3	-26.0	-16.1	-11.4

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 5%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-5.5	-72.7	-18.5	-13.0
2040	-20.0	-9.7	-77.3	-17.2	-12.1
2050	-23.2	-13.3	-80.0	-13.9	-9.8
2060	-26.2	-14.0	-81.9	-10.3	-7.3

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 3%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-5.5	-72.7	-19.8	-13.9
2040	-20.0	-9.5	-77.3	-18.5	-13.0
2050	-23.2	-13.1	-80.0	-15.2	-10.7
2060	-26.2	-13.9	-81.9	-11.6	-8.2

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 1%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-5.3	-72.7	-21.0	-14.8
2040	-20.0	-9.3	-77.3	-19.7	-13.9
2050	-23.2	-12.8	-80.0	-16.4	-11.6
2060	-26.2	-13.7	-81.9	-12.9	-9.1

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 5%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-3.1	-72.7	-18.4	-12.9
2040	-20.0	-5.4	-77.3	-16.8	-11.9
2050	-23.2	-7.9	-80.0	-13.0	-9.1
2060	-26.2	-9.3	-81.9	-8.3	-5.8

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 3%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-3.0	-72.7	-19.7	-13.8
2040	-20.0	-5.4	-77.3	-18.1	-12.8
2050	-23.2	-7.9	-80.0	-14.3	-10.1
2060	-26.2	-9.4	-81.9	-9.7	-6.8

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 1%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-3.0	-72.7	-20.9	-14.7
2040	-20.0	-5.3	-77.3	-19.4	-13.6
2050	-23.2	-7.9	-80.0	-15.6	-11.0
2060	-26.2	-9.6	-81.9	-11.0	-7.8

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 5%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-8.2	-11.2	-17.6	-12.4
2040	-20.0	-8.1	-18.3	-15.6	-11.0
2050	-23.2	-9.8	-20.7	-11.1	-7.8
2060	-26.2	-11.7	-20.1	-5.4	-3.8

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 3%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-7.7	-14.0	-18.9	-13.3
2040	-20.0	-7.3	-21.0	-17.0	-11.9
2050	-23.2	-8.9	-23.3	-12.5	-8.8
2060	-26.2	-10.8	-22.7	-6.9	-4.9

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 1%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-7.6	-16.6	-20.1	-14.2
2040	-20.0	-7.2	-23.4	-18.2	-12.8
2050	-23.2	-8.4	-25.6	-13.9	-9.8
2060	-26.2	-10.1	-25.1	-8.4	-5.9

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 5%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-8.0	-72.7	-6.7	-4.7
2040	-20.0	-13.1	-77.3	-4.3	-3.1
2050	-23.2	-17.6	-80.0	-0.6	-0.4
2060	-26.2	-18.0	-81.9	1.9	1.3

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 3%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-7.3	-72.7	-8.0	-5.7
2040	-20.0	-12.2	-77.3	-5.6	-4.0
2050	-23.2	-16.6	-80.0	-1.9	-1.3
2060	-26.2	-17.0	-81.9	0.6	0.4

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 1%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-7.2	-72.7	-9.3	-6.5
2040	-20.0	-12.0	-77.3	-6.9	-4.8
2050	-23.2	-16.2	-80.0	-3.1	-2.2
2060	-26.2	-16.6	-81.9	-0.6	-0.4

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 5%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-5.0	-72.7	-6.9	-4.8
2040	-20.0	-8.0	-77.3	-4.0	-2.8
2050	-23.2	-10.6	-80.0	0.8	0.5
2060	-26.2	-11.0	-81.9	5.5	3.9

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 3%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-4.9	-72.7	-8.1	-5.7
2040	-20.0	-7.8	-77.3	-5.3	-3.7
2050	-23.2	-10.4	-80.0	-0.5	-0.4
2060	-26.2	-11.0	-81.9	4.2	3.0

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 1%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-5.1	-72.7	-9.3	-6.6
2040	-20.0	-8.0	-77.3	-6.5	-4.6
2050	-23.2	-10.7	-80.0	-1.8	-1.3
2060	-26.2	-11.3	-81.9	2.9	2.1

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 5%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-8.9	-10.1	-5.4	-3.8
2040	-20.0	-9.4	-17.5	-1.7	-1.2
2050	-23.2	-11.2	-20.0	4.3	3.0
2060	-26.2	-12.5	-19.4	11.1	7.8

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 3%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-8.9	-12.9	-6.8	-4.8
2040	-20.0	-9.2	-20.1	-3.1	-2.2
2050	-23.2	-10.9	-22.5	2.8	2.0
2060	-26.2	-12.1	-21.9	9.5	6.7

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 1%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-8.5	-15.6	-8.0	-5.7
2040	-20.0	-8.7	-22.6	-4.4	-3.1
2050	-23.2	-10.4	-25.0	1.4	1.0
2060	-26.2	-11.6	-24.3	7.9	5.6

The excess debt buildup for this simulation prevented a solution with forward-looking capital markets.

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 5%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	.	.	.	.	.
2040	.	.	.	.	.
2050	.	.	.	.	.
2060	.	.	.	.	.

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 3%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-9.7	-72.7	-0.1	-0.1
2040	-20.0	-15.3	-77.3	3.0	2.1
2050	-23.2	-21.4	-80.0	7.0	4.9
2060	-26.2	-22.7	-81.9	8.9	6.2

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 1%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-9.2	-72.7	-1.3	-0.9
2040	-20.0	-14.7	-77.3	1.7	1.2
2050	-23.2	-20.3	-80.0	5.7	4.0
2060	-26.2	-21.4	-81.9	7.4	5.2

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 5%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-6.9	-72.7	0.8	0.6
2040	-20.0	-10.2	-77.3	4.4	3.1
2050	-23.2	-13.2	-80.0	9.6	6.7
2060	-26.2	-13.4	-81.9	13.8	9.8

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 3%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-6.7	-72.7	-0.4	-0.3
2040	-20.0	-10.1	-77.3	3.2	2.2
2050	-23.2	-13.0	-80.0	8.3	5.8
2060	-26.2	-13.2	-81.9	12.5	8.9

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 1%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-6.4	-72.7	-1.6	-1.1
2040	-20.0	-9.9	-77.3	2.0	1.4
2050	-23.2	-12.7	-80.0	7.0	5.0
2060	-26.2	-13.0	-81.9	11.3	8.0

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 5%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-7.7	-9.6	2.7	1.9
2040	-20.0	-9.0	-17.1	7.4	5.2
2050	-23.2	-11.1	-19.7	14.1	9.9
2060	-26.2	-12.0	-19.1	21.0	14.8

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 3%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-8.9	-12.4	1.3	0.9
2040	-20.0	-9.9	-19.8	6.0	4.2
2050	-23.2	-11.8	-22.3	12.6	8.9
2060	-26.2	-12.4	-21.6	19.3	13.7

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 1%
Year	Percent Uninsured*	Medicaid Enrollment	Premiums	Health Spending covered by Insurance	Total Health Spending
2030	-14.7	-8.8	-15.2	0.0	0.0
2040	-20.0	-9.5	-22.3	4.6	3.2
2050	-23.2	-11.4	-24.8	11.1	7.8
2060	-26.2	-11.9	-24.0	17.8	12.5

Except where indicated, numbers represent a percent change relative to current law.
* Percentage point difference from current law.

Table 3. Effects of Medicare for All on the Federal Budget

Financing Mechanism

Initial Drop in Total Health Expenditures

Increase in Home and Community-Based Services

Overhead Costs

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Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 3%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	22.2	4.4	8.9	0.5
2040	46.7	2.5	9.1	1.9
2050	69.1	-2.4	6.8	3.6
2060	91.6	-13.8	-1.6	5.3

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 5%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	14.2	3.7	8.2	0.5
2040	28.3	2.9	9.5	1.8
2050	40.9	0.4	9.3	3.6
2060	54.9	-5.8	5.9	5.6

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 3%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	13.3	3.6	8.2	0.5
2040	26.1	3.0	9.6	1.8
2050	38	0.9	9.8	3.6
2060	50.8	-4.7	6.9	5.7

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 1%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	11.3	3.7	8.2	0.5
2040	22.7	3.2	9.8	1.8
2050	33.5	1.4	10.2	3.6
2060	45.4	-3.4	7.9	5.7

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 5%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-24.0	0.5	109.1	0.5
2040	-38.4	0.9	135.2	1.5
2050	-47.5	2.1	163.6	3.2
2060	-53.8	4.2	199.0	6.0

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 3%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-23.8	0.7	104.5	0.5
2040	-38.2	1.3	129.7	1.5
2050	-47.5	2.6	157.3	3.3
2060	-54.0	5.0	192.0	6.1

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 1%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-23.7	0.9	100.0	0.5
2040	-38.1	1.6	124.5	1.5
2050	-47.5	3.2	151.4	3.3
2060	-54.2	5.8	185.4	6.2

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 5%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-29.7	9.7	14.1	0.7
2040	-51.5	14.8	21.2	2.5
2050	-67.8	22.1	29.9	5.7
2060	-81.5	32.5	41.1	10.3

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 3%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-29.5	9.5	13.9	0.7
2040	-51.2	14.5	20.9	2.5
2050	-67.4	21.7	29.5	5.6
2060	-81.0	32.0	40.5	10.2

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 1%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-29.2	9.2	13.7	0.7
2040	-50.7	14.2	20.6	2.5
2050	-66.8	21.3	29.1	5.6
2060	-80.2	31.5	40.0	10.1

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 5%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	24.0	4.0	8.6	0.5
2040	46.5	2.2	8.9	1.9
2050	66.5	-2.3	7.0	3.5
2060	87.1	-13.0	-0.7	5.2

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 3%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	22.2	4.0	8.5	0.5
2040	43.3	2.3	9.0	1.9
2050	62.6	-1.9	7.2	3.5
2060	82.5	-12.1	0.1	5.3

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 1%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	21.1	3.9	8.4	0.5
2040	41.4	2.3	9.0	1.9
2050	59.9	-1.7	7.5	3.5
2060	78.7	-11.3	1.0	5.3

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 5%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-15.7	0.4	111.8	0.5
2040	-22.0	-0.3	137.2	1.5
2050	-23.9	-1.4	164.3	3.1
2060	-23.1	-3.5	196.3	5.5

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 3%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-15.5	0.6	107.0	0.5
2040	-21.7	0.0	131.6	1.5
2050	-23.7	-0.9	157.8	3.1
2060	-23.0	-2.6	189.1	5.6

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 1%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-15.3	0.8	102.6	0.5
2040	-21.5	0.3	126.3	1.5
2050	-23.6	-0.4	151.8	3.2
2060	-23.0	-1.9	182.4	5.6

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 5%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-21.1	9.5	14.1	0.7
2040	-34.3	13.4	20.1	2.5
2050	-42.4	18.7	26.9	5.5
2060	-47.9	25.7	35.2	9.8

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 3%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-20.7	9.3	13.8	0.7
2040	-33.5	13.0	19.7	2.4
2050	-41.4	18.1	26.4	5.4
2060	-46.6	25.0	34.4	9.7

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 1%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-20.4	9.0	13.5	0.7
2040	-32.8	12.7	19.3	2.4
2050	-40.4	17.6	25.8	5.3
2060	-45.4	24.3	33.7	9.5

The excess debt buildup for this simulation prevented a solution with forward-looking capital markets.

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 5%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	.	.	.	.
2040	.	.	.	.
2050	.	.	.	.
2060	.	.	.	.

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 3%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	27.9	5.0	9.5	0.6
2040	57.1	2.6	9.3	2.0
2050	82.8	-2.5	6.6	3.7
2060	108.2	-14.4	-2.6	5.3

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 1%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	27.1	4.8	9.3	0.6
2040	55.4	2.4	9.2	2.0
2050	80.4	-2.8	6.4	3.7
2060	105.0	-15.1	-2.9	5.2

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 5%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-9.9	0.7	114.0	0.5
2040	-8.4	-1.0	138.8	1.5
2050	-3.4	-4.0	165.0	3.0
2060	3.8	-9.9	194.1	5.1

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 3%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-9.7	0.9	109.2	0.5
2040	-8.2	-0.7	133.2	1.5
2050	-3.3	-3.5	158.6	3.1
2060	3.9	-9.2	186.9	5.2

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 1%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-9.5	1.1	104.7	0.5
2040	-7.9	-0.4	127.9	1.5
2050	-3.0	-3.0	152.3	3.1
2060	4.1	-8.4	179.9	5.3

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 5%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-14.8	9.6	14.2	0.7
2040	-19.2	12.4	19.2	2.5
2050	-19.2	15.6	24.2	5.3
2060	-16.6	18.9	29.3	9.3

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 3%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-14.4	9.4	13.9	0.7
2040	-18.4	12.0	18.8	2.4
2050	-18.3	15.0	23.7	5.3
2060	-15.6	18.2	28.6	9.2

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 1%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-14.1	9.1	13.6	0.7
2040	-17.7	11.6	18.4	2.4
2050	-17.3	14.5	23.2	5.2
2060	-14.5	17.5	28.0	9.1

The excess debt buildup for this simulation prevented a solution with forward-looking capital markets.

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 5%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	.	.	.	.
2040	.	.	.	.
2050	.	.	.	.
2060	.	.	.	.

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 3%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	34.7	1.6	6.9	0.5
2040	70.2	-1.1	9.2	1.8
2050	99.2	-4.7	12.4	3.6
2060	123.8	-8.6	17.1	6.0

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 1%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	32.8	1.7	6.9	0.5
2040	67.4	-0.9	9.4	1.8
2050	95.4	-4.2	12.6	3.6
2060	119.3	-7.8	17.3	6.1

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 5%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-5.6	1.0	114.3	0.5
2040	1.3	-1.3	138.6	1.5
2050	10.8	-5.3	164.9	3.0
2060	21.9	-13.5	193.1	4.9

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 3%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-5.5	1.2	109.6	0.5
2040	1.5	-1.0	133.2	1.5
2050	10.9	-4.9	158.4	3.0
2060	22.1	-12.9	185.6	5.0

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 1%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-5.3	1.4	105.2	0.5
2040	1.7	-0.7	127.9	1.6
2050	11.1	-4.5	152.2	3.1
2060	22.2	-12.3	178.4	5.1

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 5%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-9.9	9.6	14.2	0.7
2040	-7.9	11.6	18.5	2.4
2050	-2.3	13.3	22.3	5.2
2060	5.5	13.8	25.1	9.0

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 3%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-10.4	9.5	14.1	0.7
2040	-8.8	11.5	18.3	2.4
2050	-3.5	13.1	22.1	5.2
2060	4.0	13.8	24.9	9.0

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 1%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-10.1	9.2	13.8	0.7
2040	-8.1	11.1	18.0	2.4
2050	-2.6	12.7	21.6	5.2
2060	5.0	13.2	24.3	8.8

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 5%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	8.2	3.6	8.1	0.5
2040	16.6	3.5	10.1	1.8
2050	25.6	2.5	11.1	3.6
2060	35.6	-1.0	10.1	5.9

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 3%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	6.8	3.7	8.1	0.5
2040	14.5	3.7	10.2	1.8
2050	22.2	2.9	11.6	3.6
2060	31.2	0.2	11.2	6.0

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 1%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	5.5	3.7	8.1	0.5
2040	11.9	3.9	10.4	1.8
2050	18.8	3.4	11.9	3.7
2060	26.8	1.2	12.0	6.0

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 5%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-23.4	1.4	89.7	0.5
2040	-37.9	2.4	112.4	1.6
2050	-47.6	4.4	137.7	3.5
2060	-54.7	7.6	169.9	6.4

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 3%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-23.3	1.6	85.6	0.5
2040	-37.9	2.8	107.5	1.6
2050	-47.6	4.9	132.1	3.5
2060	-54.9	8.3	163.6	6.5

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 1%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-23.2	1.8	81.6	0.5
2040	-37.8	3.1	102.8	1.7
2050	-47.7	5.4	126.8	3.6
2060	-55.1	9.0	157.6	6.5

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 5%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-28.7	8.7	13.1	0.7
2040	-49.7	13.5	19.8	2.4
2050	-65.3	20.4	28.1	5.4
2060	-78.5	30.3	38.8	9.9

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 3%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-28.4	8.5	12.9	0.6
2040	-49.2	13.2	19.5	2.4
2050	-64.6	20.0	27.7	5.4
2060	-77.6	29.7	38.2	9.8

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 1%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-28.2	8.3	12.7	0.6
2040	-48.8	13.0	19.3	2.4
2050	-64.1	19.6	27.3	5.4
2060	-77.0	29.3	37.8	9.7

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 5%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	17.8	3.8	8.3	0.5
2040	35.4	2.6	9.2	1.9
2050	51.5	-0.7	8.3	3.5
2060	68.4	-9.0	3.1	5.4

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 3%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	16.1	3.8	8.3	0.5
2040	32.4	2.7	9.4	1.9
2050	47.8	-0.3	8.7	3.6
2060	63.9	-7.8	4.0	5.5

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 1%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	15.1	3.8	8.3	0.5
2040	30.1	2.8	9.5	1.9
2050	44.6	0.1	9.0	3.6
2060	59.8	-6.8	4.9	5.6

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 5%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-14.9	1.3	92.2	0.5
2040	-21.1	1.1	114.0	1.6
2050	-23.4	0.8	137.7	3.3
2060	-23.1	-0.1	166.6	5.8

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 3%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-14.9	1.5	88.2	0.5
2040	-21.2	1.4	109.3	1.6
2050	-23.5	1.3	132.4	3.4
2060	-23.4	0.7	160.6	5.9

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 1%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-14.7	1.6	84.1	0.5
2040	-20.9	1.7	104.4	1.6
2050	-23.3	1.7	126.8	3.4
2060	-23.3	1.3	154.2	6.0

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 5%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-19.8	8.5	13.0	0.6
2040	-31.7	12.0	18.5	2.4
2050	-39.0	16.7	24.9	5.2
2060	-43.8	23.1	32.5	9.3

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 3%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-19.5	8.3	12.8	0.6
2040	-31.3	11.7	18.3	2.4
2050	-38.4	16.3	24.5	5.2
2060	-43.1	22.7	32.0	9.2

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 1%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-19.3	8.1	12.6	0.6
2040	-30.9	11.4	18.0	2.4
2050	-38.0	16.0	24.1	5.1
2060	-42.6	22.2	31.6	9.1

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 5%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	23.8	4.5	9.0	0.5
2040	49.3	2.4	9.1	2.0
2050	72.2	-2.5	6.7	3.6
2060	95.2	-14.3	-2.1	5.3

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 3%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	22.2	4.4	8.9	0.5
2040	46.7	2.5	9.1	1.9
2050	69.1	-2.4	6.8	3.6
2060	91.6	-13.8	-1.6	5.3

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 1%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	21.2	4.3	8.8	0.5
2040	45.0	2.4	9.1	1.9
2050	66.7	-2.2	7.0	3.6
2060	88.3	-13.2	-0.9	5.3

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 5%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-9.1	1.5	94.2	0.5
2040	-7.4	0.3	115.5	1.6
2050	-2.7	-1.9	138.1	3.2
2060	4.2	-6.7	164.0	5.4

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 3%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-9.0	1.7	90.0	0.5
2040	-7.3	0.6	110.5	1.6
2050	-2.6	-1.5	132.3	3.3
2060	4.3	-6.1	157.6	5.5

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 1%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-8.8	1.9	86.0	0.5
2040	-7.1	0.9	105.7	1.7
2050	-2.5	-1.1	126.9	3.3
2060	4.3	-5.4	151.5	5.6

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 5%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-13.5	8.6	13.1	0.7
2040	-16.8	10.9	17.7	2.4
2050	-16.2	13.6	22.2	5.1
2060	-13.2	16.4	26.8	8.9

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 3%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-13.3	8.4	12.9	0.7
2040	-16.4	10.7	17.4	2.4
2050	-15.6	13.3	21.9	5.1
2060	-12.7	15.9	26.3	8.8

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 1%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-13.1	8.2	12.7	0.7
2040	-16.0	10.4	17.1	2.4
2050	-15.1	12.9	21.5	5.0
2060	-12.1	15.5	25.9	8.7

The excess debt buildup for this simulation prevented a solution with forward-looking capital markets.

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 5%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	.	.	.	.
2040	.	.	.	.
2050	.	.	.	.
2060	.	.	.	.

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 3%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	26.4	5.1	9.6	0.6
2040	56.3	2.8	9.4	2.0
2050	83.0	-2.5	6.7	3.7
2060	108.8	-14.5	-2.6	5.3

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 1%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	25.1	5.0	9.4	0.6
2040	54.1	2.7	9.3	2.0
2050	79.9	-2.6	6.5	3.7
2060	105.3	-14.9	-2.9	5.3

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 5%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-5.1	1.8	95.2	0.5
2040	1.9	0.0	116.2	1.6
2050	11.1	-3.5	138.3	3.2
2060	22.1	-10.8	162.5	5.2

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 3%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-5.0	1.9	91.1	0.5
2040	2.0	0.2	111.3	1.7
2050	11.3	-3.1	132.6	3.3
2060	22.1	-10.2	156.0	5.3

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 1%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-4.9	2.1	87.3	0.5
2040	2.1	0.5	106.7	1.7
2050	11.3	-2.8	127.3	3.3
2060	22.1	-9.6	149.9	5.4

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 5%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-9.2	8.7	13.2	0.7
2040	-6.6	10.3	17.1	2.4
2050	-0.8	11.6	20.5	5.0
2060	7.1	11.7	22.9	8.6

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 3%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-9.0	8.5	13.0	0.7
2040	-6.2	10.1	16.9	2.4
2050	-0.3	11.3	20.1	5.0
2060	7.6	11.3	22.4	8.5

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 1%
Year	Federal Debt	Income Tax Revenue	Payroll Tax Revenue	Social Security (OASI) Spending
2030	-8.7	8.3	12.8	0.7
2040	-5.8	9.8	16.6	2.4
2050	0.3	10.9	19.8	4.9
2060	8.2	10.8	22.0	8.4

Except where indicated, numbers represent a percent change relative to current law.

Table 4. Effects of Medicare for All on the Economy

Financing Mechanism

Initial Drop in Total Health Expenditures

Increase in Home and Community-Based Services

Overhead Costs

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Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 3%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-5.9	-7.1	-9.9	4.4	6.7
2040	-9.2	-14.4	-10.2	1.1	6.2
2050	-14.3	-25.1	-10.4	-4.3	4.1
2060	-24.3	-42.5	-12.1	-13.8	-0.7

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 5%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-6.4	-7.1	-11.5	5.7	8.7
2040	-8.6	-12.0	-11.9	3.8	8.9
2050	-11.7	-18.6	-12.3	0.7	8.4
2060	-17.6	-29.6	-13.7	-4.5	6.5

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 3%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-6.5	-7.0	-11.6	5.8	8.9
2040	-8.5	-11.6	-12.0	4.1	9.3
2050	-11.3	-17.8	-12.4	1.3	9.0
2060	-16.7	-28.0	-13.7	-3.5	7.4

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 1%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-6.4	-6.8	-11.7	6.0	9.1
2040	-8.2	-11.0	-12.1	4.5	9.5
2050	-10.8	-16.7	-12.5	2.0	9.4
2060	-15.7	-26.0	-13.7	-2.3	8.0

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 5%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-8.0	-6.8	-13.9	6.9	-3.2
2040	-8.0	-6.9	-14.6	7.8	-5.4
2050	-7.2	-5.0	-15.1	9.4	-7.3
2060	-5.7	-1.1	-16.0	12.2	-9.3

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 3%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-7.8	-6.6	-13.9	7.0	-2.5
2040	-7.7	-6.6	-14.5	7.9	-4.4
2050	-6.8	-4.4	-15.0	9.6	-6.1
2060	-5.3	-0.3	-15.8	12.5	-7.9

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 1%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-7.7	-6.5	-13.8	7.1	-1.8
2040	-7.5	-6.3	-14.5	8.1	-3.6
2050	-6.5	-4.0	-14.9	9.9	-5.0
2060	-4.8	0.5	-15.7	12.9	-6.6

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 5%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-1.1	0.6	-6.4	5.7	4.8
2040	2.2	6.4	-5.2	7.8	5.9
2050	7.1	16.1	-3.7	11.2	8.0
2060	14.1	31.0	-1.9	16.3	10.7

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 3%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-1.3	0.4	-6.8	5.9	5.1
2040	1.9	6.1	-5.6	8.0	6.3
2050	6.8	15.7	-4.2	11.4	8.4
2060	13.7	30.5	-2.5	16.6	11.2

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 1%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-1.5	0.2	-7.1	6.1	5.5
2040	1.7	5.8	-6.0	8.2	6.7
2050	6.4	15.3	-4.6	11.6	8.9
2060	13.3	29.8	-3.0	16.8	11.7

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 5%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-6.2	-7.5	-10.2	4.5	7.0
2040	-9.3	-14.5	-10.6	1.4	6.6
2050	-14.2	-24.6	-10.9	-3.8	4.8
2060	-23.6	-41.1	-12.6	-12.6	0.5

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 3%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-6.2	-7.4	-10.4	4.7	7.2
2040	-9.2	-14.2	-10.8	1.7	6.9
2050	-13.9	-23.8	-11.1	-3.1	5.3
2060	-22.8	-39.5	-12.8	-11.4	1.3

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 1%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-6.3	-7.4	-10.6	4.8	7.5
2040	-9.2	-13.9	-11.0	2.0	7.3
2050	-13.6	-23.1	-11.4	-2.5	5.9
2060	-22.1	-38.3	-13.1	-10.4	2.3

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 5%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-8.0	-7.5	-13.2	5.9	-4.6
2040	-9.1	-9.8	-13.9	5.6	-7.4
2050	-10.0	-11.5	-14.7	5.5	-10.6
2060	-11.7	-13.7	-16.3	5.5	-14.3

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 3%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-7.9	-7.3	-13.1	6.0	-3.8
2040	-8.9	-9.5	-13.8	5.8	-6.5
2050	-9.7	-11.1	-14.6	5.7	-9.4
2060	-11.2	-13.0	-16.1	5.8	-12.9

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 1%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-7.8	-7.2	-13.1	6.1	-3.1
2040	-8.7	-9.2	-13.8	6.0	-5.6
2050	-9.5	-10.6	-14.5	5.9	-8.3
2060	-10.8	-12.4	-16.0	6.2	-11.6

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 5%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-1.3	-0.3	-5.8	4.8	3.8
2040	0.9	3.0	-4.5	5.7	4.3
2050	4.1	8.7	-3.1	7.4	5.4
2060	8.3	16.8	-1.6	10.1	7.1

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 3%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-1.5	-0.5	-6.2	5.0	4.2
2040	0.6	2.6	-5.1	5.9	4.7
2050	3.6	8.0	-3.7	7.6	5.9
2060	7.7	15.8	-2.3	10.3	7.6

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 1%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-1.7	-0.7	-6.6	5.2	4.5
2040	0.2	2.3	-5.6	6.1	5.2
2050	3.2	7.4	-4.3	7.8	6.4
2060	7.1	15.0	-3.0	10.5	8.0

The excess debt buildup for this simulation prevented a solution with forward-looking capital markets.

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 5%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	.	.	.	.	.
2040	.	.	.	.	.
2050	.	.	.	.	.
2060	.	.	.	.	.

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 3%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-5.5	-7.1	-8.7	3.5	5.3
2040	-9.2	-15.4	-8.7	-0.5	4.4
2050	-14.7	-27.3	-8.2	-7.1	1.4
2060	-25.3	-46.1	-8.8	-18.1	-5.0

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 1%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-5.7	-7.2	-9.0	3.7	5.7
2040	-9.3	-15.4	-9.2	-0.1	4.9
2050	-14.9	-27.1	-8.9	-6.5	2.1
2060	-25.7	-45.9	-10.1	-17.4	-3.8

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 5%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-7.8	-7.7	-12.3	5.0	-5.7
2040	-9.7	-11.8	-13.0	3.7	-9.2
2050	-12.2	-16.7	-13.8	1.8	-13.5
2060	-16.8	-24.1	-16.1	-0.9	-19.1

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 3%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-7.7	-7.6	-12.3	5.2	-5.0
2040	-9.5	-11.6	-12.9	3.9	-8.3
2050	-12.0	-16.3	-13.8	2.1	-12.3
2060	-16.4	-23.5	-16.0	-0.5	-17.6

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 1%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-7.6	-7.4	-12.3	5.3	-4.3
2040	-9.4	-11.4	-12.9	4.1	-7.4
2050	-11.7	-15.9	-13.8	2.4	-11.2
2060	-16.0	-23.0	-15.9	-0.1	-16.3

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 5%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-1.3	-0.7	-5.2	4.1	2.9
2040	-0.1	0.3	-3.9	3.9	2.8
2050	1.3	2.0	-2.5	3.9	3.0
2060	2.6	3.7	-1.3	4.0	3.3

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 3%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-1.5	-1.0	-5.6	4.3	3.3
2040	-0.4	-0.1	-4.4	4.1	3.2
2050	0.9	1.5	-3.1	4.1	3.4
2060	2.1	2.9	-2.1	4.2	3.8

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 1%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-1.7	-1.2	-6.0	4.5	3.6
2040	-0.8	-0.4	-4.9	4.3	3.6
2050	0.4	0.9	-3.7	4.3	3.9
2060	1.5	2.1	-2.7	4.4	4.2

The excess debt buildup for this simulation prevented a solution with forward-looking capital markets.

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 5%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	.	.	.	.	.
2040	.	.	.	.	.
2050	.	.	.	.	.
2060	.	.	.	.	.

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 3%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-8.4	-10.7	-12.3	4.4	8.9
2040	-13.9	-22.7	-12.7	-1.5	9.7
2050	-21.9	-38.1	-12.7	-10.6	10.5
2060	-34.0	-57.9	-12.4	-24.7	11.2

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 1%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-8.3	-10.5	-12.3	4.6	9.1
2040	-13.7	-22.2	-12.7	-1.1	9.8
2050	-21.3	-37.1	-12.7	-9.9	10.7
2060	-32.9	-56.2	-12.5	-23.3	11.5

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 5%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-7.6	-7.8	-11.5	4.4	-6.4
2040	-10.0	-13.1	-12.1	2.3	-10.3
2050	-13.5	-19.9	-12.7	-0.8	-15.4
2060	-19.7	-30.3	-15.1	-5.4	-22.4

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 3%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-7.5	-7.6	-11.5	4.5	-5.7
2040	-9.9	-12.9	-12.1	2.5	-9.4
2050	-13.2	-19.5	-12.8	-0.5	-14.2
2060	-19.4	-29.8	-15.2	-5.0	-20.9

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 1%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-7.4	-7.5	-11.5	4.6	-5.1
2040	-9.7	-12.6	-12.1	2.7	-8.5
2050	-13.0	-19.2	-12.9	-0.2	-13.1
2060	-19.1	-29.4	-15.2	-4.6	-19.5

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 5%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-1.3	-1.1	-4.8	3.7	2.3
2040	-0.9	-1.7	-3.4	2.6	1.8
2050	-0.7	-2.6	-2.0	1.4	1.3
2060	-1.5	-5.3	-1.1	-0.3	0.7

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 3%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-1.4	-1.2	-5.1	3.9	2.6
2040	-1.0	-1.7	-3.8	2.9	2.1
2050	-0.8	-2.6	-2.6	1.8	1.7
2060	-1.5	-5.1	-1.7	0.2	1.2

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 8%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 1%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-1.6	-1.4	-5.5	4.1	2.9
2040	-1.3	-2.0	-4.3	3.1	2.5
2050	-1.2	-3.1	-3.1	2.0	2.1
2060	-2.0	-5.8	-2.3	0.3	1.5

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 5%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-6.4	-6.6	-12.0	6.3	9.5
2040	-7.9	-10.1	-12.4	5.2	10.2
2050	-9.9	-14.7	-12.8	3.3	10.5
2060	-13.7	-22.0	-13.8	0.1	9.8

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 3%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-6.4	-6.5	-12.1	6.5	9.7
2040	-7.8	-9.7	-12.5	5.5	10.5
2050	-9.5	-13.7	-12.9	3.8	10.9
2060	-12.8	-20.2	-13.8	1.2	10.5

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 1%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-6.4	-6.3	-12.2	6.6	9.9
2040	-7.5	-9.2	-12.6	5.8	10.7
2050	-9.1	-12.8	-12.9	4.4	11.3
2060	-12.0	-18.6	-13.8	2.1	11.1

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 5%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-7.4	-6.1	-13.7	7.3	-0.2
2040	-7.0	-5.5	-14.3	8.5	-1.5
2050	-5.8	-2.8	-14.7	10.4	-2.5
2060	-3.7	2.3	-15.3	13.7	-3.5

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 3%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-7.3	-5.9	-13.7	7.4	0.4
2040	-6.8	-5.2	-14.2	8.6	-0.7
2050	-5.5	-2.3	-14.6	10.7	-1.5
2060	-3.3	3.0	-15.2	14.0	-2.2

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 1%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-7.2	-5.8	-13.6	7.5	1.0
2040	-6.7	-5.0	-14.2	8.7	0.1
2050	-5.3	-1.9	-14.6	10.9	-0.5
2060	-2.9	3.7	-15.0	14.3	-1.1

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 5%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-1.9	-0.2	-7.9	6.4	6.3
2040	1.0	5.1	-7.0	8.6	7.7
2050	5.6	14.3	-5.8	12.1	10.0
2060	12.2	28.4	-4.3	17.3	12.9

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 3%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-2.1	-0.4	-8.2	6.6	6.6
2040	0.8	4.9	-7.4	8.8	8.1
2050	5.3	13.8	-6.3	12.3	10.4
2060	11.8	27.7	-4.9	17.5	13.4

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 0%
Overhead Costs: 1%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-2.3	-0.5	-8.4	6.7	6.9
2040	0.6	4.7	-7.7	9.0	8.5
2050	5.0	13.5	-6.6	12.5	10.8
2060	11.4	27.2	-5.3	17.7	13.8

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 5%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-6.4	-7.2	-11.0	5.2	8.1
2040	-8.9	-13.0	-11.4	2.8	8.1
2050	-12.8	-21.2	-11.8	-1.1	7.0
2060	-20.2	-34.6	-13.4	-7.8	4.2

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 3%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-6.3	-7.1	-11.2	5.4	8.3
2040	-8.7	-12.5	-11.6	3.2	8.4
2050	-12.4	-20.3	-12.0	-0.5	7.5
2060	-19.3	-32.9	-13.5	-6.7	5.0

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 1%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-6.3	-7.0	-11.3	5.6	8.5
2040	-8.6	-12.2	-11.7	3.5	8.6
2050	-12.1	-19.5	-12.1	0.1	7.9
2060	-18.5	-31.4	-13.6	-5.7	5.6

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 5%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-7.5	-6.9	-13.1	6.4	-1.5
2040	-8.3	-8.6	-13.7	6.4	-3.5
2050	-8.8	-9.6	-14.4	6.5	-5.7
2060	-9.8	-10.8	-15.6	6.9	-8.4

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 3%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-7.4	-6.7	-13.0	6.5	-0.9
2040	-8.1	-8.3	-13.7	6.5	-2.8
2050	-8.5	-9.2	-14.3	6.7	-4.7
2060	-9.4	-10.1	-15.5	7.3	-7.2

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 1%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-7.3	-6.6	-13.0	6.5	-0.3
2040	-7.9	-8.1	-13.7	6.7	-1.9
2050	-8.3	-8.8	-14.2	6.9	-3.7
2060	-9.0	-9.5	-15.4	7.5	-6.0

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 5%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-2.2	-1.1	-7.3	5.6	5.3
2040	-0.4	1.6	-6.5	6.6	6.1
2050	2.4	6.5	-5.5	8.3	7.4
2060	6.1	13.7	-4.3	10.9	9.1

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 3%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-2.4	-1.3	-7.6	5.7	5.6
2040	-0.6	1.4	-6.9	6.7	6.5
2050	2.1	6.1	-5.9	8.5	7.8
2060	5.7	13.1	-4.8	11.1	9.6

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 50%
Overhead Costs: 1%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-2.5	-1.4	-7.9	5.9	5.9
2040	-0.8	1.2	-7.2	6.9	6.8
2050	1.8	5.8	-6.3	8.7	8.2
2060	5.4	12.6	-5.4	11.3	10.0

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 5%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-5.9	-7.1	-9.7	4.3	6.4
2040	-9.2	-14.7	-9.9	0.8	5.9
2050	-14.5	-25.7	-10.1	-4.9	3.6
2060	-24.8	-43.6	-11.7	-14.8	-1.5

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 3%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-5.9	-7.1	-9.9	4.4	6.7
2040	-9.2	-14.4	-10.2	1.1	6.2
2050	-14.3	-25.1	-10.4	-4.3	4.1
2060	-24.3	-42.5	-12.1	-13.8	-0.7

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 1%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-6.0	-7.1	-10.1	4.6	7.0
2040	-9.1	-14.2	-10.4	1.4	6.6
2050	-14.1	-24.6	-10.7	-3.8	4.7
2060	-23.8	-41.4	-12.5	-12.9	0.2

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 5%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-7.4	-7.1	-12.2	5.5	-2.7
2040	-9.0	-10.8	-12.9	4.5	-5.3
2050	-11.2	-15.0	-13.7	2.9	-8.6
2060	-15.1	-21.6	-15.6	0.7	-13.1

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 3%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-7.3	-7.0	-12.2	5.6	-2.1
2040	-8.8	-10.5	-12.9	4.7	-4.5
2050	-10.9	-14.7	-13.7	3.2	-7.6
2060	-14.7	-21.1	-15.5	1.0	-11.8

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 1%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-7.2	-6.9	-12.2	5.7	-1.5
2040	-8.7	-10.3	-12.9	4.8	-3.7
2050	-10.7	-14.3	-13.6	3.4	-6.6
2060	-14.3	-20.5	-15.5	1.3	-10.6

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 5%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-2.2	-1.6	-6.7	4.9	4.4
2040	-1.3	-1.0	-5.9	4.8	4.6
2050	-0.3	0.0	-4.9	4.8	4.9
2060	0.6	0.9	-4.0	4.8	5.3

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 3%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-2.3	-1.7	-7.0	5.0	4.7
2040	-1.6	-1.3	-6.2	5.0	4.9
2050	-0.6	-0.3	-5.3	5.0	5.3
2060	0.2	0.5	-4.5	5.0	5.7

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 200%
Overhead Costs: 1%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-2.5	-1.9	-7.3	5.2	5.0
2040	-1.8	-1.5	-6.6	5.1	5.3
2050	-0.9	-0.6	-5.8	5.1	5.7
2060	-0.1	0.0	-5.1	5.2	6.1

The excess debt buildup for this simulation prevented a solution with forward-looking capital markets.

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 5%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	.	.	.	.	.
2040	.	.	.	.	.
2050	.	.	.	.	.
2060	.	.	.	.	.

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 3%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-5.4	-6.9	-8.7	3.6	5.4
2040	-9.0	-15.2	-8.7	-0.4	4.5
2050	-14.7	-27.3	-8.2	-7.1	1.5
2060	-25.5	-46.3	-8.9	-18.2	-4.9

Financing Mechanism: Deficit
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 1%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-5.5	-6.9	-9.0	3.8	5.7
2040	-9.1	-15.0	-9.1	0.0	4.9
2050	-14.7	-26.9	-8.8	-6.5	2.1
2060	-25.6	-45.9	-9.9	-17.4	-4.0

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 5%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-7.2	-7.2	-11.6	4.9	-3.5
2040	-9.4	-12.1	-12.2	3.2	-6.5
2050	-12.5	-18.4	-12.9	0.5	-10.6
2060	-18.3	-28.2	-15.2	-3.6	-16.3

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 3%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-7.1	-7.1	-11.6	5.1	-2.9
2040	-9.2	-11.9	-12.2	3.4	-5.7
2050	-12.3	-18.1	-13.0	0.7	-9.5
2060	-18.0	-27.7	-15.2	-3.3	-15.0

Financing Mechanism: Payroll
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 1%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-7.0	-7.0	-11.6	5.2	-2.3
2040	-9.1	-11.7	-12.2	3.5	-5.0
2050	-12.1	-17.7	-13.0	1.0	-8.6
2060	-17.7	-27.2	-15.2	-2.9	-13.8

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 5%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-2.1	-1.9	-6.3	4.5	3.8
2040	-2.0	-2.8	-5.4	3.6	3.5
2050	-2.1	-4.2	-4.4	2.4	3.1
2060	-3.2	-7.3	-3.8	0.6	2.5

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 3%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-2.3	-2.0	-6.5	4.6	4.0
2040	-2.2	-3.0	-5.7	3.7	3.8
2050	-2.4	-4.5	-4.8	2.5	3.5
2060	-3.5	-7.8	-4.2	0.8	2.9

Financing Mechanism: Premium
Initial Drop in Total Health Expenditures: 16%
Increase in Home and Community-Based Services: 300%
Overhead Costs: 1%
Year	GDP	Capital Stock	Hours Worked	Output per Hour Worked	Consumption
2030	-2.5	-2.1	-6.8	4.7	4.3
2040	-2.4	-3.2	-6.1	3.9	4.2
2050	-2.7	-4.9	-5.3	2.7	3.9
2060	-3.9	-8.2	-4.8	0.9	3.3

Except where indicated, numbers represent a percent change relative to current law.