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. 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. He and co-author Micah Johnson laid out their vision in the 2021 book Medicare for All: A Citizen’s Guide , which offers the clearest picture of how the policy could take shape as progressives grow in Congress. A “core tenet” of the policy, they write, is comprehensive coverage: physician visits, prescription drugs, and emergency services, potentially extending to long-term care, vision, and dental. El-Sayed has also pitched the system as more durable than employer-based coverage. “Turn 26, get a job, lose a job, get married, get divorced: none of these would cost you your health insurance under Medicare for All,” he wrote in the same Senate testimony. The policy still has vocal critics, from pharmaceutical companies to the American Hospital Association. Any bill would likely need 60 votes to clear a Senate filibuster, plus President Trump’s signature. Senate seat was never the goal,” El-Sayed told supporters early Wednesday. “The goal is to use that seat to transform our politics.”