H.R. 3069 — Medicare for All Act (As Amended)
Universal Medicare Trust Fund
Universal Medicare Trust Fund
(a) In General.There is hereby created on the books of the Treasury a trust fund to be known as the Universal Medicare Trust Fund, consisting of such gifts and bequests as may be made and such amounts as may be deposited in, or appropriated to, the Trust Fund as provided in this Act.
(b) Appropriations Into Trust Fund.There are appropriated to the Trust Fund for each fiscal year, beginning with the year that includes the date benefits first become available, amounts equivalent to 100 percent of the net increase in revenues attributable to the amendments made by sections 801 and 902. For the fiscal year containing January 1 of the first year following enactment, there is appropriated an amount equal to the aggregate amounts appropriated for the preceding fiscal year for Medicare; Medicaid; the Federal Employees Health Benefits program; the purchased care component of TRICARE; the maternal and child health program; vocational rehabilitation; drug abuse and mental health services; and other Federal programs to the extent they pay for health services.
(c)–(d)The provisions of subsections (b) through (i) of section 1817 of the Social Security Act shall apply to the Trust Fund. Any amounts remaining in the Federal Hospital Insurance Trust Fund or the Federal Supplementary Medical Insurance Trust Fund, after claims under title XVIII are completed, shall be transferred into the Universal Medicare Trust Fund.
Working-People-First Revenue — Largest Burdens on Largest Profits
Graduated Employer Health Contribution
There is hereby imposed on every employer a graduated health contribution on wages paid to employees, scaled by employer size. No employer is categorically exempt; the only employers that do not contribute under this section are those with gross annual revenue below $500,000 that operate at a loss. The graduated payroll rate structure is as follows:
- 1Under $200,000 in gross revenue — if profitable0.5% payroll
- 2Under $200,000 in gross revenue — operating at a lossNo contribution
- 3$200,000 to $500,000 in gross revenue — if profitable0.75% payroll
- 4$200,000 to $500,000 in gross revenue — operating at a lossNo contribution
- 5$500,000 to $2,500,000 in gross revenue1.5% payroll
- 6$2,500,000+ to $5,000,000 in gross revenue2.5% payroll
- 7$5,000,000+ to $10,000,000 in gross revenue3.5% payroll
- 8500 to 4,999 employees and revenue above $10 million5.5% payroll
- 95,000 or more employees7.5% payroll
The Secretary of the Treasury shall adjust all thresholds annually for inflation beginning in Year 3. The corporate profit levy is set out separately in Section 705. Estimated annual revenue — employer payroll contribution: ≈ $500 billion Estimate.
Individual Income-Based Premium
Every household with annual income below $50,000 is fully exempt from any contribution under this section. No exceptions, no paperwork, no means testing beyond income verification already conducted by the Internal Revenue Service. A family earning $49,999 pays nothing.
Every household with annual income between $50,000 and $100,000 shall contribute $100 per month to the Universal Medicare Trust Fund. The employer of each contributing employee shall match this dollar-for-dollar. Combined annual contribution per worker: $2,400 ($1,200 employee + $1,200 employer).
A family earning $65,000 currently pays an average of $6,296 per year in employee premium contributions plus $3,564 out-of-pocket; under this structure they pay $1,200. Their employer, who currently pays over $13,000, pays $1,200. Both save money; both get better coverage. Estimated annual revenue (net of tax offsets): $79 billion Estimate.
High-Earner Contribution
Every employee earning in excess of $100,000 annually shall contribute $150 per month to the Universal Medicare Trust Fund, matched dollar-for-dollar by the employer, for a combined contribution of $300 per month. This contribution is in addition to the employer payroll contribution under Section 702.
A worker earning $120,000 contributes $1,800 per year; their employer matches $1,800. The worker currently pays an average of $7,884 per year in employer-sponsored premium contributions; under this structure they pay $1,800 — a savings of $6,084 for the employee alone. Estimated annual revenue (net of tax offsets): $135 billion Estimate.
Excess Corporate Profit Levy
A levy shall be imposed on the net profits of corporations as follows, applied on profits above each threshold only. This is the sole corporate profit levy under this Act; it complements, and does not duplicate, the employer payroll contribution of Section 702.
- ①Annual net profit exceeding $500 million3% on excess
- ②Annual net profit exceeding $1 billion6% on excess
- ③Annual net profit exceeding $10 billion10% on excess
Corporations with annual net profit below $500 million are fully exempt. Small and mid-size businesses are completely unaffected. This places the entire weight on the ultra-profitable: the largest technology corporations, Wall Street financial institutions, energy companies, and pharmaceutical manufacturers — Apple, Microsoft, Google, JPMorgan, Exxon and their peers pay the most.
Note on private health insurers. UnitedHealth Group, CVS Health/Aetna, Cigna, Elevance Health, Humana, Centene, and all other private health insurers whose primary business is selling duplicative coverage are not projected as profit-levy contributors because their core business ceases to exist under Section 107. The approximately $350 billion they collectively extracted annually is recaptured by eliminating their market entirely, not by taxing their continued operation. No transition assistance under Section 601(b) shall be provided to executives, board members, or shareholders of these entities; assistance shall be provided to their rank-and-file employees. Estimated annual profit-levy revenue: $185–220 billion Estimate.
Financial Transactions Tax
A tax of 0.1 percent shall be imposed on the sale or exchange of stocks, bonds, derivatives, and other financial instruments. Individual retail investors with transaction volumes under $25,000 annually, and qualified retirement accounts under sections 401(k) and 403(b), are fully exempt. The Secretary shall promulgate regulations implementing this tax in a manner that does not impede ordinary retirement savings or middle-class wealth accumulation.
Estimated annual revenue: ≈ $78 billion Gov Data — the Congressional Budget Office and Joint Committee on Taxation score a 0.1% financial transactions tax at roughly $777 billion over ten years.
Corporate Tax Restoration
The corporate income tax rate is hereby restored to 28 percent for corporations with annual net income above $10,000,000. Corporations with net income below $10,000,000 retain the current statutory rate. This restoration reverses a portion of the 2017 corporate tax reduction with respect to large profitable corporations only.
Estimated annual revenue: ≈ $100 billion Gov Data — restoring the rate to 28% is scored at roughly $1.0 trillion (Tax Foundation) to $1.4 trillion (Treasury) over ten years; shown here at the conservative end.
Mandatory Tax Reduction Trigger
(a) Automatic Tax Reduction.When the Comptroller General verifies that the Program has achieved net savings of 5, 10, 15, or 20 percent below the CBO baseline projection for total national health expenditures, the corresponding percentage of the additional revenues generated by sections 702 through 707 shall be automatically and proportionally returned to taxpayers through reductions in the rates imposed under those sections.
(b) Implementation.The Secretary of the Treasury shall, within 90 days of each verification, implement the proportional rate reductions for the next succeeding tax year. Such reductions shall be permanent unless reversed by a subsequent verification showing savings have fallen below the relevant threshold.
This section ensures that savings achieved by this Act flow back to the American people rather than being captured by the Federal Government as additional revenue. As the system grows more efficient, taxpayers pay less. The trigger is self-executing and does not require new authorizing legislation.