How Abdul El-Sayed would build Medicare for All, from a wealth tax to a Fed-style governing board

Near the end of his victory speech in Detroit early Wednesday, Senator-elect Abdul El-Sayed returned to the line that carried his campaign: “It shouldn’t be this hard to see a doctor in the richest, most powerful country in the world.”

El-Sayed defeated Republican Mike Rogers in Michigan’s open Senate race on a night when Democrats captured both chambers of Congress. He arrives in Washington as one of the country’s most prominent advocates of Medicare for All, a public, universal, single-payer system, and as the co-author of a detailed plan for how it would work.

The issue resonated with voters in both parties. In the NBC News Exit Poll, which surveyed more than 79,000 voters, 85% said they were very or somewhat concerned about healthcare costs. Sixty-one percent said the federal government should play a bigger role in helping Americans get it.

Democrats campaigned on healthcare costs across the country, but the party is split on the fix. Many moderates want to strengthen the Affordable Care Act, which expanded coverage through Medicaid and subsidized private marketplaces. For El-Sayed and other progressives, Medicare for All remains the gold standard, and a single public payer would replace much of the private insurance business that sustains some of America’s largest companies.

UnitedHealth Group is No. 3 on the 2026 Fortune 500 and the biggest healthcare company on the list. CVS Health, which owns Aetna, ranks No. 6, and Elevance Health ranks No. 18. El-Sayed has singled out the industry before: in 2022, in written testimony to the Senate Budget Committee, he noted that UnitedHealth’s second-quarter profit in 2020 nearly doubled from a year earlier.

El-Sayed, 42, holds a medical degree and a doctorate, ran Detroit’s health department from 2015 to 2017, and later directed Wayne County’s........

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