Michigan Democrat Abdul El-Sayed has spent years promoting the end of private insurance as part of his Medicare for All plan. A couple of weeks ago, however, he said some people could be allowed to keep private coverage if they could afford it.

Now El-Sayed is back with another explanation, and this one puts the federal government squarely in control. Under his latest description, the government would become the insurer because it would essentially purchase healthcare for everyone.

“You guarantee government healthcare for everyone,” El-Sayed said. “Number one, it means you're gonna have healthcare.”

“Number two, government's big enough to be like 'You're not gonna raise rates anymore' because we're the only one paying.”

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That is El-Sayed’s sales pitch for handing Washington enormous power over healthcare payments. His argument is that the government would be large enough to dictate rates because providers would have nowhere else to go for payment.

“You know what a monopoly is right?” he continued. “A monopoly's when there's one seller of a good.”

“The one seller gets to be like here's what I'm selling for so you gotta buy. There's this other thing we don't talk about called a monopsony, which is the one buyer of a good.”

El-Sayed then described the federal government occupying that position across the healthcare system. “If the government is everybody's insurer, it's basically buying for everybody.”

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The obvious problem is that making the government the dominant buyer does not make costs or shortages disappear. If rates cannot rise, hospitals and providers still must manage expenses, creating the prospect of rationed services, longer waits, and denied care.

The host pushed El-Sayed to clarify the practical result of his proposal. “So you remove the insurance companies and the government is now the insurer?” the host asked.

“Government becomes the insurer,” El-Sayed replied. That answer strips away the soothing language and gets to the heart of the plan: Americans would depend on Washington rather than the current insurance system.

El-Sayed attempted to leave a narrow opening for private companies. “Insurance companies can do what they want. They wanna offer a luxury product for a couple folks ... but you don't rely on the insurance system.”

JUST NOW: El-Sayed confirms Medicare for All would get rid of private insurance plans

Abdul: “If the government is everybody’s insurer, it’s basically buying [healthcare] for everybody” Host: "So you remove the insurance companies and government is now the insurer?" Abdul: "Government becomes the insurer" Abdul goes on to say insurance companies will be allowed to offer "luxury products for a couple folks" — Kyle Martinsen (@KyleMartinsen_) October 21, 2026

That is hardly a promise that Americans could simply keep the private coverage they already have. Private insurance would instead be pushed toward a luxury option available to a limited group, while the government system became the standard for everyone else.

Such a transformation would also require the government to finance coverage on an enormous scale. The resulting tax burden could make today’s premiums and copayments look inexpensive, even as Americans surrendered control to a federal system.

The plan therefore does not eliminate reliance on a massive institution. It merely replaces insurance companies with the federal government, an institution that can be even more soulless than the corporations Democrats routinely attack.

The proposal also carries political consequences for organized labor. Unions with favorable healthcare arrangements could find little comfort in watching those plans replaced, potentially pushing members toward Republicans unless Democrats created special arrangements for them.

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— Hugh Hewitt (@hughhewitt) October 21, 2026

Then there is the workforce already tied to health insurance and related fields. Millions of people work in those industries, and under the scenario described, they could lose their jobs or become government employees.

A reminder that this is Peggy Flanagan’s proposal, which would eliminate 50,000 private sector jobs in Minnesota overnight between just three companies.

— Dustin Grage (@GrageDustin) October 21, 2026

El-Sayed’s shifting explanations do little to resolve those concerns. First came years of support for ending private insurance, then a suggestion that some people could retain it, and now an admission that the government would become the insurer.

The latest comments reveal what the softer language cannot conceal. Medicare for All, as El-Sayed describes it, would move Americans away from relying on private insurance and toward relying on Washington for their healthcare coverage.

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