Implementing a universal healthcare system like Medicare for All would require a massive increase in government spending—estimated at $32.6 trillion over 10 years, according to a 2022 study by the Mercatus Center. This would be in addition to the U.S. national debt, which surpassed $35 trillion in 2024 and continues to climb. Notably, even without this added cost, the U.S. is already experiencing its highest debt-to-GDP ratio since World War II—equating to over $100,000 in debt per American citizen.

Covering the cost of such an initiative would likely require one or more of the following:

1. Significant tax increases across all income levels, not just for the wealthy
2. Unprecedented government borrowing, further driving up interest payments (already exceeding $800 billion annually)
3. Cuts to other essential government services

Each of these options would carry serious implications for the American public.

Under M4A, the influx of new patients into the healthcare system could overwhelm providers, resulting in longer wait times for appointments, surgeries, and procedures. Countries with universal healthcare, like Canada, have experienced issues with wait times for certain procedures. A 2022 poll also shows that Canadians are less satisfied with their access to healthcare than Americans.