The True Cost of Peggy Flanagan’s Medicare for All Plan

Key findings

1. Flanagan supports Medicare for All and has said she wants to work with Bernie Sanders to pass it, but her campaign has not released a detailed financing proposal explaining how she would fund the massive expansion of federal healthcare spending.
2. Independent estimates find a comprehensive Medicare for All system could require roughly $25 trillion to $35 trillion in additional federal financing over a decade. Taxes on corporations and high earners alone would not come close to covering the cost.
3. The Committee for a Responsible Federal Budget estimates financing a $30 trillion Medicare for All program could require the equivalent of a new 32% payroll tax, a 25% income surtax, or a 42% value-added tax.
4. Lower provider reimbursement is one of the primary ways single-payer proposals attempt to control spending, potentially putting additional pressure on hospitals and healthcare workers. Minnesota’s rural healthcare system is already vulnerable to relatively small reimbursement reductions.
5. Flanagan acknowledges the transition would affect healthcare workers but offers no detailed plan for dealing with those disruptions, saying only that policymakers must “consider the impact on workers across the board.”

Full report

## Full Report ## Flanagan Embraces Medicare for All Peggy Flanagan has made government-run healthcare a significant part of her Senate platform. Her campaign declares healthcare a human right and says she will “fight for Medicare for All,” while expanding Medicare and Medicaid benefits in the meantime and further increasing federal involvement in prescription drug pricing. Her position is considerably further left than a simple public option or expansion of the Affordable Care Act. During Minnesota’s Democratic Senate primary, Flanagan repeatedly invoked Medicare for All as an example of the “big, bold change” she believes Democrats should pursue. She also criticized her primary opponent for receiving support from healthcare interests that oppose the proposal and said she wanted to work with Sanders to enact it. What Flanagan has not offered is an equally bold explanation of the bill. Her campaign platform does not specify the tax increases she would support to finance Medicare for All, what reimbursement rates hospitals and doctors would receive, or precisely how Minnesotans with employer-sponsored and private coverage would transition into the new system. Instead, her campaign acknowledges broadly that policymakers would need to “consider the impact on workers across the board” during the transition. ## The Financing Reality: Trillions in New Federal Spending Moving the country to a comprehensive Medicare for All system would shift an extraordinary amount of healthcare spending onto the federal budget. The Committee for a Responsible Federal Budget estimates that a comprehensive Medicare for All system could require $25 trillion to $35 trillion in new federal financing over ten years, depending on the details of the program. CRFB concluded that taxes confined to high earners, corporations and the financial sector would cover only a fraction of that cost. Using a $30 trillion estimate, CRFB calculated that financing the program could require the equivalent of a 32% payroll tax, a 25% income surtax above the standard deduction, or a 42% value-added tax. Alternatively, the government could more than double individual and corporate income tax rates, slash most non-health federal spending, or dramatically increase the national debt. Those figures illustrate the central problem missing from Flanagan’s campaign pitch: universal coverage may eliminate premiums and reduce some out-of-pocket costs, but it does not eliminate the underlying cost of healthcare. It transfers much of that cost to taxpayers. Flanagan has made opposition to corporate influence and demands that wealthy Americans pay more central themes of her campaign. But even extraordinarily large tax increases on the wealthy would be insufficient to finance a Medicare for All program of this scale, according to CRFB. ## Minnesota Hospitals Could Face New Financial Pressure The financing problem does not end with taxes. Lower payments to doctors, hospitals and other providers are one of the principal mechanisms through which single-payer proposals attempt to control healthcare spending. The Congressional Budget Office says reduced provider payment rates are among the major sources of savings under illustrative single-payer systems, while also noting that lower reimbursement would flow through to wages in the healthcare sector. That tradeoff could be particularly consequential in Minnesota, where rural healthcare providers are already operating under financial pressure. The Chartis Center for Rural Health found that 46% of rural hospitals nationally operated with negative margins in its 2025 analysis. Even a comparatively modest 2% Medicare sequestration reduction was projected to cost rural hospitals nationally more than $509 million, with Minnesota hospitals facing an estimated $23 million hit — among the largest impacts of any state. Minnesota has also already lost significant rural healthcare capacity. Chartis found that 19 rural Minnesota hospitals stopped offering obstetrics services between 2011 and 2023, the second-highest number in the country. That makes reimbursement policy more than an abstract budget question. A Medicare for All system that achieves savings by squeezing provider payments could place additional strain on facilities already struggling to maintain staff and services. ## More Coverage Also Means More Demand Medicare for All advocates frequently emphasize the savings that could come from reduced administrative costs and lower prices. But universal first-dollar coverage also encourages greater healthcare utilization. CBO's analysis of single-payer systems identifies greater use of healthcare as one of the major forces pushing national health expenditures upward, partially offsetting savings from lower administrative spending and reduced provider payments. That creates another tradeoff largely absent from Flanagan’s campaign rhetoric. Expanding coverage can improve access for people who currently forgo care because of cost, but the resulting increase in demand requires enough doctors, nurses, hospital capacity and funding to treat those additional patients. Reducing provider payments at the same time that demand rises risks creating pressure on both the healthcare workforce and access to services — precisely why the details of reimbursement and financing matter. ## Conclusion Peggy Flanagan presents Medicare for All as the kind of “big, bold change” Washington needs. What her campaign has not provided is an equally detailed account of what that change would cost Minnesotans. The Medicare for All model Flanagan has aligned herself with would represent one of the largest expansions of the federal government in modern history, shifting trillions of dollars in healthcare spending onto Washington. Independent estimates show that financing a comprehensive plan cannot realistically be accomplished by taxing billionaires and corporations alone and would require substantial additional revenue from the broader tax base. At the same time, controlling the program’s costs would likely depend heavily on lower payments to healthcare providers, creating risks for Minnesota hospitals already facing tight margins and disappearing rural services. Flanagan has made clear that she wants Medicare for All. What remains unclear is how much she expects Minnesotans to pay for it — and what their healthcare system would look like once the bill comes due. ## References [1] Peggy Flanagan for Minnesota — Healthcare Priorities https://peggyflanagan.com/priorities/ [2] MPR News — Beyond the nasty ads, there are key differences between Craig and Flanagan, July 27, 2026 https://www.mprnews.org/story/2026/07/27/dfl-senate-hopefuls-craig-flanagan-differ-on-healthcare-israel-and-affordability [3] Twin Cities PBS — 2026 DFL U.S. Senate Primary Debate, June 19, 2026 https://www.pbs.org/video/dfl-primary-us-senate-debate-sefhgt/ [4] Congressional Budget Office — Economic Effects of Five Illustrative Single-Payer Health Care Systems https://www.cbo.gov/publication/57637 [5] Congressional Budget Office — How CBO Analyzes Proposals for a Single-Payer Health Care System https://www.cbo.gov/publication/56898 [6] Committee for a Responsible Federal Budget — Choices for Financing Medicare for All https://www.crfb.org/papers/choices-financing-medicare-all [7] Chartis Center for Rural Health — 2025 Rural Health State of the State https://www.chartis.com/insights/2025-rural-health-state-state

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