(c) MAINTENANCE OF MEDICAID ELIGIBILITY AND 
BENEFITS.—In order for a State to continue to be eligible 
for payments under section 1903(a) of the Social Security 
Act (42 U.S.C. 1396b(a)) the State may not reduce stand-
ards of eligibility, cost-sharing requirements, or benefits 
provided under its State Medicaid plan under title XIX 
of the Social Security Act below such standards of eligi-
bility and benefits in effect on the date of the enactment 
of this Act. 
SEC. 3. FINANCING THROUGH EMPLOYMENT TAX. 
(a) TAX ON EMPLOYEES.—Section 3101 of the Inter-
nal Revenue Code of 1986 is amended by redesignating 
subsection (c) as subsection (d) and by inserting after sub-
section (b) the following new subsection: 
‘‘(c) MEDICARE FOR ALL.— 
‘‘(1) IN GENERAL.—In addition to other taxes, 
there is hereby imposed on the income of every indi-
vidual a tax equal to 1.7 percent of the wages (as 
defined in section 3121(a)) received by him with re-
spect to employment (as defined in section 3121(b)) 
that are in excess of $25,000. The preceding sen-
tence shall not apply to wages received by an indi-
vidual with respect to employment during any period 
unless the individual (or a family member of the in-
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dividual) is enrolled in the program under title XXII 
of the Social Security Act during such period. 
‘‘(2) INFLATION ADJUSTMENT.—In the case of 
any taxable year beginning in a calendar year after 
2008, the dollar amount contained in paragraph (1) 
shall be increased by an amount equal to— 
‘‘(A) such dollar amount, multiplied by 
‘‘(B) the cost-of-living adjustment deter-
mined under section 1(f)(3) for the calendar 
year in which the taxable year begins, by sub-
stituting ‘calendar year 2007’ for ‘calendar year 
1992’ in subparagraph (B) thereof. 
If any increase determined under the preceding sentence 
is not a multiple of $50, such increase shall be rounded 
to the next lowest multiple of $50.’’. 
(b) TAX
ON EMPLOYERS.—Section 3111 of such 
Code is amended by redesignating subsection (c) as sub-
section (d) and by inserting after subsection (b) the fol-
lowing new subsection: 
‘‘(c) MEDICARE
FOR ALL.—In addition to other 
taxes, there is hereby imposed on every employer an excise 
tax, with respect to having individuals in his employ, equal 
to 7 percent of the wages (as defined in section 3121(a)) 
paid by him with respect to employment (as defined in 
section 3121(b)). The preceding sentence shall not apply 
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to wages paid with respect to employment of an individual 
during any period unless the individual (or a family mem-
ber of the individual) is enrolled in the program under title 
XXII of the Social Security Act during such period.’’. 
(c) TAX ON SELF-EMPLOYMENT.—Section 1401 of 
such Code is amended by redesignating subsection (c) as 
subsection (d) and by inserting after subsection (b) the 
following new subsection: 
‘‘(c) MEDICARE
FOR ALL.—In addition to other 
taxes, there shall be imposed for each taxable year, on the 
self-employment income of every individual, a tax equal 
to the applicable percent of the self-employment income 
for such taxable year. For purposes of the preceding sen-
tence, the applicable percent is a percent equal to the sum 
of the percent described in section 3101(c) (but only with 
respect to self-employment income that is in excess of the 
amount described in paragraph (1) of such section, as ad-
justed under paragraph (2) of such section) plus the per-
cent described in section 3111(c). This subsection shall 
not apply to self-employment income of an individual for 
a taxable year unless the individual (or a family member 
of the individual) is enrolled in the program under title 
XXII of the Social Security Act during such taxable 
year.’’. 
(d) RAILROAD RETIREMENT TAX.— 
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(1) TAX ON EMPLOYEES.—Section 3201(a) of 
such Code is amended by striking ‘‘subsections (a) 
and (b) of section 3101’’ and inserting ‘‘subsections 
(a), (b), and (c) of section 3101’’. 
(2) TAX ON EMPLOYEE REPRESENTATIVES.— 
Section 3211(a) of such Code is amended by striking 
‘‘subsections (a) and (b) of section 3101 and sub-
sections (a) and (b) of section 3111’’ and inserting 
‘‘subsections (a), (b), and (c) of section 3101 and 
subsections (a), (b), and (c) of section 3111’’. 
(3) TAX ON EMPLOYERS.—Section 3221(a) of 
such Code is amended by striking ‘‘subsections (a) 
and (b) of section 3111’’ and inserting ‘‘subsections 
(a), (b), and (c) of section 3111’’. 
(4) 
DETERMINATION
OF
CONTRIBUTION 
BASE.—Clause (iii) of section 3231(e)(2)(A) is 
amended to read as follows: 
‘‘(iii) 
HOSPITAL
INSURANCE
AND 
MEDICARE
FOR
ALL
TAXES.—Clause (i) 
shall not apply to— 
‘‘(I) so much of the rate applica-
ble under section 3201(a) or 3221(a) 
as does not exceed the sum of the 
rates of tax in effect under sub-
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sections (b) and (c) of section 3101, 
and 
‘‘(II) so much of the rate applica-
ble under section 3211(a) as does not 
exceed the sum of the rates of tax in 
effect under subsections (b) and (c) of 
section 1401.’’. 
(e) APPLICATION OF TAX TO FEDERAL, STATE, AND 
LOCAL EMPLOYMENT.—Paragraphs (1) and (2) of section 
3121(u) and section 3125(a) of such Code are each 
amended by striking ‘‘sections 3101(b) and 3111(b)’’ and 
inserting ‘‘subsections (b) and (c) of section 3101 and sub-
sections (b) and (c) of section 3111’’. 
(f) CONFORMING AMENDMENTS.— 
(1) Section 1402(a)(12)(B) of such Code is 
amended by striking ‘‘subsections (a) and (b) of sec-
tion 1401’’ and inserting ‘‘subsections (a), (b), and 
(c) of section 1401’’. 
(2) Section 3121(q) of such Code is amended 
by striking ‘‘subsections (a) and (b) of section 
3111’’ and inserting ‘‘subsections (a), (b), and (c) of 
section 3111’’. 
(3) The last sentence of section 6051(a) of such 
Code is amended by striking ‘‘sections 3101(c) and 
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3111(c)’’ and inserting ‘‘sections 3101(d) and 
3111(d)’’. 
(g) EFFECTIVE DATE.—The amendments made by 
this section shall apply to wages paid and self-employment 
income derived on or after January 1 of the year following 
the date of the enactment of this Act. 
SEC. 4. COLLECTIVELY BARGAINED PLANS. 
(a) IN GENERAL.—Except as provided in subsection 
(c), nothing in this Act, or the amendments made by this 
Act, shall be construed as affecting obligations to provide 
or fund health care benefits under any group health plan 
established or maintained under or pursuant to one or 
more collective bargaining agreements between employee 
representatives and one or more employers in effect on the 
date of enactment of this Act. 
(b) APPLICATION.—The Medicare for All program 
under title XXII of the Social Security Act, as added by 
section 2(a), shall not apply to eligible individuals (as de-
fined in section 2202(a)(2) of such Act (as so added)) cov-
ered by a group health plan described in subsection (a) 
until the applicable collective bargaining agreement termi-
nates. 
(c) LIMITING BENEFITS TO INDIVIDUALS NOT YET 
ELIGIBLE FOR MEDICARE FOR ALL.—A group health plan 
described in subsection (a) may, in accordance with an 
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agreement between the parties, limit coverage under the 
plan to individuals who are not eligible for benefits under 
such Medicare for All program. 
Æ 
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