Medicare for All is back in the conversation, and so is the price tag. Marc Goldwein, senior vice president and senior policy director at the Committee for a Responsible Federal Budget, said the program could cost the government $20 trillion to $40 trillion over a decade. That is a lot of money, even by Washington standards.

Goldwein shared the estimates on X in response to Sen.-elect Troy Jackson of Maine, who called for Medicare for All, prescription drug reform, Social Security changes and a higher minimum wage. Jackson said voters had given Democrats a mandate for 'real reform' and that he was willing to work with Republicans.

In a Tuesday appearance on MS NOW's Morning Joe, Jackson said he wanted to debate Medicare for All, reform prescription drug policy, raise the minimum wage and fix Social Security. Asked about working with Republicans, he said they would need to move away from income-tax cuts for wealthy people.

Goldwein Breaks Down the Costs of Democratic Reforms

Goldwein did not just drop a giant number and walk away. He broke down the moving pieces. Prescription drug reform could save several hundred billion dollars on its own, and in the context of Medicare for All, could save as much as $3 trillion. Raising the minimum wage could cost $50 billion to $200 billion. Saving Social Security could save $3 trillion over a decade. He noted that the details of any proposal would matter, which is the policy equivalent of saying the devil is in the fine print.

Sanders Renews Call for Medicare for All

The debate over the potential cost comes as Sen. Bernie Sanders (I-Vt.) renewed his push for the proposal. In a Friday post on X, Sanders shared a clip from his appearance on The Weekly Show with Jon Stewart, writing, 'Democrats now have the opportunity to do some big things — including Medicare for All. Let's hope they don't blow it.'

During the conversation, Sanders described Medicare for All as a 'four-year proposal,' meaning a plan spanning four years. He did not explain the specific stages or implementation timeline in the clip, but said, 'We've got to start it.' He warned that Democrats could be facing their 'last chance' to show working Americans that government could deliver concrete improvements to their lives.

Sanders also proposed a 5% annual tax on billionaires, which he estimated could raise about $400 billion a year. He said the revenue could help fund 7 million low-income and affordable housing units, universal free childcare, free public colleges and universities, and a $3,000 first-year stipend for working-class Americans.

Questions Over Medicare for All Funding

The proposed expansion of Medicare has also raised questions about how Democrats would finance it. Former Rep. Marjorie Taylor Greene challenged Sanders' Medicare for All push, asking, 'Is the plan to raise taxes?' She warned that higher taxes on an already highly taxed public would be unpopular.

The financing debate also drew attention to healthcare costs, with Florida surgeon John Asghar estimating that Medicare for All could require $3 trillion in additional annual federal funding by 2030. Investor Mark Cuban argued that a lack of pricing transparency could leave the government 'negotiating blind' when trying to control those costs.

So the argument is not just about whether Medicare for All is a good idea. It is about whether the math works, who pays for it, and whether Democrats can sell it to voters who are already feeling squeezed. Sanders says this is the moment. Goldwein's numbers suggest the moment comes with a very large bill.