CBO May, 2019
At a Glance
Some Members of Congress have proposed establishing a single-payer health care system in the United States to ensure that virtually everyone has health insurance. In a typical single-payer system, people enroll in a health plan operated by the government, and the receipts and expenditures associated with the
plan appear in the government’s budget.
This report describes the primary features of single-payer systems, and it discusses some of the design considerations and choices that policymakers will face as they develop proposals for establishing such a system in the United States. The report does not address all of the issues involved in designing,
implementing, and transitioning to a single-payer system, nor does it analyze the budgetary effects of any specific proposal.
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