Sen. Elizabeth Warren (D-Massachusetts) proposed a $20.5 trillion in new spending for a “Medicare for All” plan, funded by huge tax increases on businesses and the wealthy.

Under Warren’s plan, which she insists will not cost the middle class an extra penny, all employer-sponsored health insurance would be eliminated and replaced by free government health coverage for all Americans, a progressive shift away from the traditionally capitalist-driven healthcare sector.

She plans to finance the plan in a variety of ways.

In her proposal, employers would be required to pay the government about what they currently pay to private insurance companies. She would add a tax to financial transactions, such as stock trades and ramp up taxes on the top 1%. She also plans to cut $800 billion of the military budget and reallocate it to fund Medicare for All.

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In addition to this funding, local and state governments would have to finance $6.1 trillion, on top of the $20.5 trillion, to help support the plan.

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The plan would eliminate premiums, deductibles and other out-of-pocket expenses for Americans.

Kate Bedingfield, a deputy campaign manager for Joe Biden, said the plan is “unrealistic” and added that requiring employers to pay in would “fall on American workers.”

“The mathematical gymnastics in this plan are all geared towards hiding a simple truth from voters: It’s impossible to pay for Medicare for all without middle-class tax increases,” Bedingfield said in a statement.

The cost of Medicare for All is largely contingent on how much doctors and hospitals would be paid. Private insurance pays doctors significantly more.

“This plan aggressively constrains the price of health care, paying doctors, hospitals and drug companies much less,” Larry Levitt, executive vice president for health policy at the Kaiser Family Foundation told NPR. “There would be a lot of adjustment required from from hospitals and doctors as their incomes go down.”

Healthcare has become a highly contested issue in this presidential election, with both Warren and Bernie Sanders splitting away from the traditional Democratic agenda by rolling out government-funded healthcare plans for everyone.

Sanders has proposed a similar plan to Warren’s, although he has not worked out all the numbers yet. Unlike Warren, he has acknowledged that taxes for the middle class would increase and has talked about raising taxes by 4% for anyone making above $29,000 per year.

“At the end of the day, the overwhelming majority of people will save money on their health care bills. But I do think it is appropriate to acknowledge that taxes will go up,” he said at the Democratic debate in October.

“They’re going to go up significantly for the wealthy. And for virtually everybody, the tax increase they pay will be substantially less — substantially less than what they were paying for premiums and out-of-pocket expenses,” he said.

Biden, who is polling on average 8.8 points higher than Warren, has pledged to uphold the Affordable Care Act passed under Obama. While the Affordable Care Act has created a public health insurance option and reduced the overall number of uninsured Americans, it still provided ample room for private health insurance.

Pete Buttigieg, who is in fourth in the polls, has taken a stance similar to Biden. His campaign touts the idea of “Medicare for All Who Want It,” which would allow individuals to opt-in to a publicly funded insurance program.

“This affordable public plan will incentivize private insurers to compete on price and bring down costs. If private insurers are not able to offer something dramatically better, this public plan will create a natural glide-path to Medicare for All,” Buttigeg’s campaign website explains. “The choice of a public plan empowers people to make their own decisions regarding the type of health care that makes sense for them by leveling the playing field between patients and the health care system.”

According an NPR/PBS NewsHour/Marist poll, the more moderate health plans proposed by Biden and Buttigieg are favored by more Americans in comparison to fully-funded government healthcare for all.

The poll found that 70% of Americans favored a Medicare program people can opt-in to, over the 41% that said they would support a program that would nearly eliminate all private insurance, such as Warren is proposing.

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