evidence: Originally introduced by Sen. Bernie Sanders, the Medicare for All Act of 2019 (S.1129) would provide universal health insurance to U.S. residents and displace almost all private insurers. Benefits under Medicare for All would be very generous. This program would cover a much broader range of services than current Medicare, including dental, vision, hearing, and home and community-based long-term care. And under Medicare for All, participants would have no copayments or premiums. [...] Sanders’ bill, as written, contains no plan to pay for the costs of Medicare for All, and so—following long-standing conventions — we score it as increasing deficits. Despite the potential cost savings described above, we project that Sanders’ bill would increase the federal debt by 92 percent in 2060. This increase swamps the economic boost from a healthier, larger population, and creates a drag on long-run economic growth. [...] Although it’s missing from his bill, Sanders has stated his intention to pay for Medicare for All through higher taxes. Recognizing this, we analyzed two alternative financing options: increasing the payroll tax rate and a new, flat insurance premium on all workers (subsidized for lower-income workers). Under the payroll tax financing option, the economy is 15 percent smaller in 2060. Under the premium financing option, the economy is slightly larger in 2060, by about 0.2 percent.