The Centers for Medicare and Medicaid Services reported U.S. national health expenditures reached $4.9 trillion, or 17.6% of GDP, in 2023.
The U.S. Census Bureau estimated 25.3 million Americans, or 7.7% of the population, were uninsured at some point in 2023.
A 2020 Congressional Budget Office analysis estimated that a single-payer system could lower administrative costs but would require substantial new federal spending and tax revenue to replace private premiums.
Supporters argue a single-payer system would guarantee universal coverage and reduce per-capita spending; critics argue it would raise federal taxes, lengthen wait times, and disrupt employer-sponsored coverage held by roughly 153 million Americans.
Enacting single-payer would require an act of Congress; bills such as the Medicare for All Act have been introduced repeatedly since 2003 but have not received a floor vote in either chamber.