Medicare for Anyone Who Wants It
Let any Utahn buy Medicare. Keep your plan if you like it. Pay based on what you earn. Get checkups for free. Keep your HSA. And seniors on Medicare today don't lose a thing.
The idea in one sentence
Today, Medicare is only for people 65 and older. I’d open it up so anyone can buy it: a young family, a self-employed contractor, a 58-year-old who got laid off, or a small business that wants to cover its workers.
Nobody is forced to switch. Nobody loses the plan they have. It’s simply one more choice, and it’s a good one.
Why we need it
Health insurance costs too much. The average family plan at work now costs more than $28,000 a year when you add up what the worker and the employer pay. For families who buy their own insurance, premiums more than doubled this year after Washington let the tax credits expire.
Medicare costs less because it pays fair prices. Private insurance pays hospitals about two and a half times what Medicare pays for the same care. That difference ends up in your premium.
How it works
1. You choose
You can buy the Medicare plan during open enrollment each year, the same as any other plan. If you like your current plan, keep it. If Medicare is a better deal, switch.
2. Three simple plans
Just like at work: single, couple, and family. A family plan costs the same whether you have one child or five.
My early estimate of the full price:
| Plan | Full price per year | Per month |
|---|---|---|
| Single | about $5,300 | about $440 |
| Couple | about $10,600 | about $880 |
| Family | about $15,500 | about $1,290 |
3. You pay based on what you earn
No family should spend more than 8.5% of its income on a health plan. If the full price is more than that, a tax credit covers the difference. Lower-income families pay little or nothing.
What singles would pay:
| Single, yearly income | Yearly premium |
|---|---|
| $25,000 | about $100 |
| $35,000 | about $1,030 |
| $45,000 | about $2,480 |
| $55,000 | about $4,010 |
| $62,000 and up | $5,300 (full price) |
What couples would pay:
| Couple, yearly income | Yearly premium |
|---|---|
| $35,000 | about $220 |
| $50,000 | about $1,730 |
| $65,000 | about $4,020 |
| $80,000 | about $6,370 |
| $125,000 and up | $10,600 (full price) |
4. Free checkups, fair copays
- Free for everyone: checkups, screenings, vaccines, prenatal care, kids’ doctor visits, and a quick video visit when you have a cold or the flu.
- A modest copay for a sick visit, based on what you earn.
- A higher copay for using the ER when it isn’t an emergency. Save the ER for real emergencies.
- A hard yearly limit on what you can spend out of pocket, so one bad year can’t bankrupt your family.
5. Keep your HSA
Health savings accounts are one of the best tax breaks a working family can get. Money goes in tax-free, grows tax-free, and comes out tax-free for medical bills. In 2027, a family can put away up to $9,000 a year.
Today, though, signing up for Medicare means you can’t put new money into an HSA. I’d fix that. The Medicare buy-in would come in two versions:
- Medicare Standard: lower deductible, with the copays above.
- Medicare Saver: a lower premium and a higher deductible, built to work with an HSA. Checkups and video visits are still free before you meet the deductible.
Congress already made this kind of change last year, when it let families with bronze and catastrophic marketplace plans open HSAs. Medicare Saver extends the same idea to the Medicare buy-in.
6. Small businesses can buy in too
A small business could offer the Medicare plan to its workers instead of shopping for a private plan every year. Whatever it saves can go to raises or to growing the business. That’s the owner’s call.
What this means if you’re already on Medicare
Nothing changes for you. People who buy in pay their own premiums, kept in a separate account. Not one dollar comes from the Medicare trust fund that seniors paid into. Your benefits, your doctors, and your costs stay the same.
Questions people ask
Will this overcrowd the health care system?
Most people who buy in already have insurance. They’re just switching plans, so they’re not new patients. Some uninsured people will get covered, and that’s the point. But covered patients tend to get care earlier, at a doctor’s office instead of an emergency room. Free checkups and video visits help keep small problems from becoming big ones.
We do need more doctors. Experts project a shortage of up to 86,000 doctors by 2036, mostly because the country is getting older. I’d back the bipartisan effort to fund more medical residency positions, so more doctors can finish training, especially in rural Utah.
Will this cost taxpayers more money?
The plan pays for itself through premiums. The help for lower-income families comes from the same marketplace tax credits that exist today, which I’d restore and pay for by ending hospital billing markups. And because the Medicare plan costs less than most private plans, a family that switches needs a smaller credit. That saves taxpayers money.
Can I keep my regular doctor?
Very likely, yes. Almost every doctor in America takes Medicare. About 9 in 10 doctors accept new Medicare patients, and only about 1% have opted out. Unlike many private plans, Medicare doesn’t lock you into a narrow network. Any doctor who takes Medicare, anywhere in the country, would take this plan.
Will doctors be on board?
Most already are, because they already see Medicare patients every day. The buy-in would pay a little more than regular Medicare, with extra help for rural hospitals. Doctors also get one set of rules instead of dozens of insurance company rulebooks, which means less paperwork.
Hospitals are a different story. They make more money from private insurance, and some will push back. I’ll be honest about that. But families shouldn’t pay double so hospitals can charge double.
Is this a government takeover of health care?
No. Nobody is forced into anything. Private insurance stays, job-based plans stay, and you decide. Medicare just becomes one more choice, and private insurers will have to compete to keep your business. That’s how a market is supposed to work.
What about pre-existing conditions?
Covered, the same as every plan today. Nobody can be turned away or charged more because they’ve been sick.
Why not just put everyone on Medicare?
Because most Utahns want a choice, and many like the plan they have. If Medicare is the better deal, people will choose it. If it isn’t, they won’t. Let families decide.
Can people wait until they’re sick to sign up?
No. Like every other plan, you sign up once a year during open enrollment. That keeps the plan affordable for everyone.
The bottom line
Health care in America costs too much, and families are tired of being told there’s nothing anyone can do. Here’s something we can do: let anyone buy Medicare, help working families afford it, and let them decide. If you like your plan, keep it. If you want something better, it’s there.
Sources
- KFF: 2026 Employer Health Benefits Survey (average premiums $9,804 single, $28,303 family)
- KFF: marketplace premium payments more than doubled after tax credits expired
- RAND: private plans pay hospitals about 254% of Medicare prices
- State Health and Value Strategies: the 2021–2025 tax credit schedule
- IRS-based summary: 2027 HSA limits ($4,500 single, $9,000 family)
- KFF Health System Tracker: Medicare enrollees can’t contribute to HSAs; bronze and catastrophic plans now HSA-eligible
- AAMC via Becker’s: shortage of up to 86,000 doctors by 2036
- Becker’s: bipartisan bill to add 14,000 residency positions
- KFF: 89% of doctors accept new Medicare patients; 1% opted out