A new report on Sen. Bernie Sanders' "Medicare for All" plan outlined a whopping cost for the federal government. But the price tag may not be as overall eye-catching as it initially seems.
The report, from the libertarian Mercatus Center, found that Sanders' plan to extend Medicare to all Americans would increase federal healthcare costs by $32.6 trillion from 2022 to 2031 if implemented as written.
Republicans pounced on the number, arguing that it showed such a plan was not feasible.
House Speaker Paul Ryan tweeted: "$32.6 trillion dollars. That's how much Washington Democrats' single-payer healthcare proposal would cost over 10 years. Even doubling all federal individual and corporate income taxes wouldn't cover this cost. It is just absurd."
But the cost for the federal government tells only part of the story. The government is one piece of the health-system puzzle.
The Department of Health and Human Services also measures the total amount spent on healthcare in the US, including by states, private citizens, the federal government, businesses, and more. This all-encompassing number is known as the national health expenditure, or NHE.
According to the Mercatus model, total health spending would actually come in about $303 billion lower in 2031 than under current projections, with $7.35 trillion going to healthcare that year versus $7.65 trillion expected now. Total national health spending would be $2 trillion lower from 2022 to 2031 under the plan, the report found.
While the price tag for the federal government would increase significantly, decreased spending by other groups would lower total healthcare spending over that 10-year period. Meanwhile, the model also assumes that 30 million more people would get access to healthcare, and many people would get more robust services.
The savings would come from a variety of places, such as the government's ability to leverage its bargaining power into lower prescription-drug costs and mandating all healthcare providers take the lower Medicare payment rate.
The study contains assumptions, and there are numerous political and practical concerns in shifting the burden of healthcare payments to the federal government. But based on the Mercatus model, tens of millions of uninsured Americans would get access to healthcare, and the US as a whole would end up spending less than it is expected to right now.