Reference

Every input number

All 248 raw numbers the site uses, defined once in one file and reused everywhere. "Data" means a published statistic, "policy" a choice the plan makes, and "estimate" our assumption.

Population groups (coverage)

Input	Value	Kind
U.S. resident population, 50 states + DC, July 2025 (millions) residentPop2025 Sources: U.S. Census Bureau (2026)	341.78	datahigh confidence
U.S.-born citizens, 2024 (millions, civilian noninstitutionalized) usBornCitizens Sources: KFF (2025)	281.59	datahigh confidence
Naturalized citizens, 2024 (millions) naturalizedCitizens Sources: KFF (2025)	25.61	datahigh confidence
Lawful permanent residents, January 2024 (millions) lawfulPermanentResidents Sources: Migration Policy Institute (2026)	12.8	datahigh confidence
Resident nonimmigrants (work and student visas and families), FY2019 (millions) nonimmigrantResidents Latest DHS estimate is for FY2019. Sources: DHS Office of Homeland Security Statistics (2023)	3.2	datamedium confidence
Unauthorized immigrants, 2023, Pew (millions) unauthorizedHigh Includes about 6 million people with temporary protections (TPS, pending asylum). Sources: Pew Research Center (2025)	14	datamedium confidence
Unauthorized immigrants, January 2022, DHS (millions) unauthorizedLow Sources: DHS Office of Homeland Security Statistics (2024)	11	datamedium confidence
New lawful permanent residents admitted from abroad, FY2024 (millions) newLprArrivals Sources: Migration Policy Institute (2026)	0.574	datahigh confidence
International visitor arrivals, 2025 (millions) visitorArrivals Sources: International Trade Administration (2026)	68.3	datahigh confidence
People uninsured all of 2025 (millions) uninsuredToday Sources: U.S. Census Bureau (2026)	26.7	datahigh confidence
Added uninsured from repealing the mandate, CBO projection for 2027 (millions) mandateRepealUninsured2027 Sources: Congressional Budget Office (2017)	13	estimatemedium confidence
Active-duty members and families eligible for TRICARE, FY2024 (millions) tricareActiveFamilies Sources: Defense Health Agency (2025)	2.82	datahigh confidence
Veterans enrolled in VA health care (millions) vaEnrolled Sources: U.S. Department of Veterans Affairs (2025)	9.1	datahigh confidence
People served by the Indian Health Service (millions) ihsServed Sources: Indian Health Service (2026)	2.8	datahigh confidence
People in prisons and jails, yearend 2023 (millions) incarcerated Sources: Bureau of Justice Statistics (2025)	1.853	datahigh confidence
Puerto Rico population, July 2025 (millions) puertoRicoPop Sources: U.S. Census Bureau (2026)	3.185	datahigh confidence
Guam, U.S. Virgin Islands, American Samoa, Northern Mariana Islands, 2020 (millions) otherTerritoriesPop Sources: U.S. Census Bureau (2021)	0.338	datahigh confidence
Health spending per unauthorized immigrant vs per U.S.-born person, 2017 ($1,629 vs $6,088) unauthorizedSpendShare Sources: JAMA Network Open (2020)	26.8%	datamedium confidence

Population & economy

Input	Value	Kind	Used in
U.S. population, 2024 (millions, CMS-implied: $5,278.6B ÷ $15,474) population Sources: CMS Office of the Actuary (2025)	341.1	datahigh confidence	Enrollment, health cards & outreach
U.S. households, 2024 (millions) households Census CPS ASEC household count. Sources: U.S. Census Bureau (2022)	132.2	datahigh confidence	Enrollment, health cards & outreach
Wages & salaries, 2024 wageBase Sources: BEA via FRED (2025)	$12,388B	datahigh confidence	Employer health payroll tax (new) Federal employer health payroll tax (new) State & local employer health payroll tax (new)
Private-industry wages & salaries (Q4 2024 annual rate) privateWages Sources: BEA via FRED (2025)	$10,739B	datahigh confidence	Employer health payroll tax (new) Federal employer health payroll tax (new) State & local employer health payroll tax (new)
Government wages & salaries (Q4 2024 annual rate) governmentWages Sources: BEA via FRED (2025)	$1,887B	datahigh confidence	Employer health payroll tax (new) Federal employer health payroll tax (new) State & local employer health payroll tax (new)
Federal share of government wages (civilian + military) federalShareOfGovWages Sources: BEA via FRED (2025)	23%	estimatemedium confidence	Employer health payroll tax (new) Federal employer health payroll tax (new) State & local employer health payroll tax (new)
Adjusted gross income, tax year 2022 agi2022 Sources: IRS Statistics of Income (2024)	$15,100B	datahigh confidence	Income-based health premium (new)
AGI growth 2022 → 2024 agiGrowth2022to2024 Roughly nominal wage + capital income growth over two years.	6%	estimatemedium confidence	Income-based health premium (new)
AGI removed by household exemptions agiExempted Most low-income returns use their full exemption; ~160M returns × an average ~$20k exemption, less unused exemption.	$3,200B	estimatemedium confidence	Income-based health premium (new)
Average annual NHE growth, 2024–2033 (CMS projection) nheGrowth CMS projects ~$8.6T by 2033. Sources: CMS Office of the Actuary (2025)	5.6%	datahigh confidence	Ten-year federal window (2027–2036)
Medicare enrollees, 2024 (millions) medicareEnrollees Sources: CMS Office of the Actuary (2025)	66.6	datahigh confidence
Medicare Advantage enrollees (millions) maEnrollees Sources: Medicare Payment Advisory Commission (2025)	33	datahigh confidence
People with employer coverage, 2024 (millions) esiPeople Sources: CMS Office of the Actuary (2025)	178.6	datahigh confidence

Premiums & cost sharing (2025)

Input	Value	Kind
Average family premium, employer plan familyPremium Sources: KFF (2025)	$26,993	datahigh confidence
Average single premium, employer plan singlePremium Sources: KFF (2025)	$9,325	datahigh confidence
Worker contribution, family workerFamilyContribution Sources: KFF (2025)	$6,850	datahigh confidence
Worker contribution, single workerSingleContribution Sources: KFF (2025)	$1,440	datahigh confidence
Medicare Part B standard premium, per month partBMonthly Sources: Medicare Trustees (2025)	$185	datahigh confidence
Typical Part D premium, per month partDMonthly	$50	estimatemedium confidence
Typical Medigap Plan G premium, per month medigapMonthly	$200	estimatemedium confidence
ACA out-of-pocket maximum, single oopMaxSingle	$9,200	datahigh confidence
ACA out-of-pocket maximum, family oopMaxFamily	$18,400	datahigh confidence

Prices & payment rates

Input	Value	Kind	Used in
Private hospital prices as a multiple of Medicare (RAND, employer plans) randHospitalMultiple Sources: RAND Corporation (2024)	2.54×	datahigh confidence
Private hospital prices vs Medicare, all private (blended) privateHospitalMultiple RAND's 254% is employer plans; Marketplace and other contracts pay less. Sources: RAND Corporation (2024)	2.2×	estimatemedium confidence
Private physician prices vs Medicare privatePhysicianMultiple Sources: Medicare Payment Advisory Commission (2025)	1.4×	estimatemedium confidence
Medicaid physician fees vs Medicare medicaidFeeIndex Sources: KFF (2019)	0.72×	datahigh confidence
Medicaid hospital payments vs Medicare (incl. supplemental) medicaidHospitalIndex Sources: MACPAC (2017)	0.9×	estimatemedium confidence
Hospital Medicare fee-for-service margin, 2023 hospitalMedicareMargin Sources: Medicare Payment Advisory Commission (2025)	-13%	datahigh confidence
Traditional Medicare administrative cost share medicareAdminShare Sources: Medicare Trustees (2025)	1.4%	datahigh confidence	Public program administration
Billing & insurance-related cost share of hospital revenue hospitalBirShare Sources: Jiwani et al., BMC Health Services Research (2014)	8.5%	datahigh confidence	Hospital billing costs avoided
Billing & insurance-related cost share of physician revenue physicianBirShare Sources: Jiwani et al., BMC Health Services Research (2014)	13%	datahigh confidence	Physician billing costs avoided
Share of billing costs eliminated under one payer birReduction	50%	estimatemedium confidence	Hospital billing costs avoided Physician billing costs avoided
Medicare Advantage payments above FFS-equivalent maOverpayment Sources: Medicare Payment Advisory Commission (2025)	20%	datahigh confidence
Brand-name share of retail drug spending brandShareOfRetailRx Sources: RAND Corporation (2024)	80%	estimatemedium confidence	Pharmaceutical manufacturer revenue
Average brand net price reduction from national negotiation brandPriceCut Sources: CMS (2024); RAND Corporation (2024)	35%	estimatemedium confidence	Pharmaceutical manufacturer revenue
Medicare FFS improper payment rate, FY2024 improperPaymentRate Sources: CMS (2024)	7.7%	datahigh confidence

Plan policy parameters

Input	Value	Kind	Used in
UHP hospital payment rate (× Medicare) hospitalRate	1.2×	policyhigh confidence
UHP physician payment rate, average (× Medicare) physicianRate	1.12×	policyhigh confidence
UHP primary-care rate (× Medicare) primaryCareRate	1.25×	policyhigh confidence
UHP procedural-specialty rate (× Medicare) proceduralRate	1.05×	policyhigh confidence
Rural physician add-on ruralAddOn	10%	policyhigh confidence
UHP administration as a share of benefits uhpAdminRate Sources: Medicare Trustees (2025); Canadian Institute for Health Information (2024)	2.5%	policyhigh confidence	Public program administration
New residency positions residencySlots Sources: AAMC (2024)	14,000	policyhigh confidence	Workforce capacity investment
Hospital budget quality withhold qualityWithhold	2%	policyhigh confidence
Hospital budget volume corridor (±) volumeCorridor	3%	policyhigh confidence
Physician opt-out commitment optOutYears	2 years	policyhigh confidence
Duplicative-insurance ban before mandatory review duplicativeBanYears	10 years	policyhigh confidence
Wait-guarantee voucher payment (× UHP rate) guaranteeVoucherRate	1.5×	policyhigh confidence
Residency requirement for eligibility (days) residencyDays	90	policyhigh confidence
Pharmacy dispensing fee per prescription dispensingFee	$10.5	policyhigh confidence
Integrated care organization capitation (share of expected spending) icoDiscount	97%	policyhigh confidence
Maintenance-of-compensation requirement maintenanceOfCompYears	3 years	policyhigh confidence
Provider rate convergence period rateConvergenceYears	4 years	policyhigh confidence
State MOE as share of 2024 Medicaid + buy-in spending stateMoeShare	100%	policyhigh confidence	State Medicaid share → UHP maintenance-of-effort payment
Spending growth target: GDP per capita growth + … spendingTargetMargin	0.5%	policyhigh confidence
Trust fund contingency reserve (months of benefits) reserveMonths	2	policyhigh confidence

Taxes & revenue

Input	Value	Kind	Used in
Employer health payroll tax rate employerTaxRate	7.5%	policyhigh confidence	Employer health payroll tax (new) Federal employer health payroll tax (new) State & local employer health payroll tax (new) Employer: Small business, no coverage +4 more
Payroll exempt per employer payrollExemption	$250,000	policyhigh confidence	Employer health payroll tax (new) Federal employer health payroll tax (new) State & local employer health payroll tax (new) Employer: Small business, no coverage +4 more
Share of total payroll exempted by the $250k exemption smallEmployerExemptShare Sources: U.S. Census Bureau (2022)	6%	estimatemedium confidence	Employer health payroll tax (new) Federal employer health payroll tax (new) State & local employer health payroll tax (new)
Self-employment earnings exempt from the employer-equivalent tax seThreshold	$50,000	policyhigh confidence
Household income-based premium rate householdPremiumRate	4%	policyhigh confidence	Income-based health premium (new)
Household exemption: 1 person exemptionSingle	$16,000	policyhigh confidence	Income-based health premium (new)
Household exemption: 2 people exemptionCouple	$24,000	policyhigh confidence
Household exemption: 3 people exemptionThree	$28,000	policyhigh confidence
Household exemption: 4 people exemptionFour	$32,000	policyhigh confidence	Income-based health premium (new)
Household exemption: each additional person exemptionPerExtra	$4,000	policyhigh confidence
Surtax rate above $1M AGI surtaxRate	7%	policyhigh confidence	Top-end surtaxes & financial transactions tax (new)
Surtax threshold surtaxThreshold	$1,000,000	policyhigh confidence
AGI above $1M per return, summed incomeAboveMillion Sources: IRS Statistics of Income (2024)	$1,930B	estimatelow confidence	Top-end surtaxes & financial transactions tax (new)
Surtax yield lost to avoidance surtaxBehavioral Applied through the conservative income base above.	0%	estimatelow confidence
Capital gains & dividends as ordinary income above $1M capGainsRevenue Sources: Joint Committee on Taxation / Treasury Green Book (2024)	$90B	estimatelow confidence	Top-end surtaxes & financial transactions tax (new)
Financial transactions tax rate fttRate	0.1%	policyhigh confidence	Top-end surtaxes & financial transactions tax (new)
Financial transactions tax revenue after behavioral response fttRevenue Sources: Congressional Budget Office (2024)	$75B	estimatelow confidence	Top-end surtaxes & financial transactions tax (new)
Other: caps on remaining health-benefit deductions deductionCapRevenue	$30B	estimatelow confidence	Top-end surtaxes & financial transactions tax (new)
Top ordinary income tax rate topRateOrdinary	37%	datahigh confidence
Top long-term capital gains rate topRateCapGains	20%	datahigh confidence
Employer FICA rate employerFica	7.65%	datahigh confidence
Employee FICA rate employeeFica	7.65%	datahigh confidence
Medicare HI payroll tax (employer + employee) hiRate	2.9%	datahigh confidence	Employer Medicare payroll tax (1.45%) Worker & self-employed Medicare payroll tax
Social Security payroll tax (employer + employee) ssRate	12.4%	datahigh confidence	Federal income tax on former premium dollars (new)
Average federal income tax rate on newly taxable compensation federalMarginalRate Sources: Congressional Budget Office (2024)	18%	estimatemedium confidence	Federal income tax on former premium dollars (new)
Average state income tax rate on newly taxable compensation stateMarginalRate	3.5%	estimatemedium confidence	Federal income tax on former premium dollars (new)
Employer savings passed to wages wagePassThrough Sources: Baicker & Chandra, Journal of Labor Economics (2006)	85%	estimatemedium confidence	Federal income tax on former premium dollars (new)
Federal tax subsidy for employer coverage, 2024 esiTaxExclusion Sources: Congressional Budget Office (2024)	$400B	datamedium confidence
State premium taxes paid by health insurers statePremiumTax Sources: National Association of Insurance Commissioners / state revenue reports (2024)	$18B	estimatelow confidence	Insurer & plan overhead eliminated State & local government budgets
Standby prescription copays (if activated) copayStandbyRevenue	$15B	estimatelow confidence
Broad VAT revenue per percentage point vatPerPoint Sources: Congressional Budget Office (2024)	$60B	estimatelow confidence
CBO single-payer options: change in national health spending, 2030, low end cboSinglePayerNationalLow Sources: Congressional Budget Office (2020)	$-700B	datahigh confidence
CBO single-payer options: change in national health spending, 2030, high end cboSinglePayerNationalHigh Sources: Congressional Budget Office (2020)	$300B	datahigh confidence
CBO single-payer options: added federal subsidies, 2030, low end cboSinglePayerFederalLow Sources: Congressional Budget Office (2020)	$1,500B	datahigh confidence
CBO single-payer options: added federal subsidies, 2030, high end cboSinglePayerFederalHigh Sources: Congressional Budget Office (2020)	$3,000B	datahigh confidence

Insurer overhead breakdown

Input	Value	Kind	Used in
Private health insurer profit (underwriting + fees) insurerProfit Sources: NAIC (2024)	$42B	estimatelow confidence	Insurer & plan overhead eliminated Insurer shareholder value at risk
Broker & agent commissions and marketing brokerCommissions	$32B	estimatelow confidence	Insurer & plan overhead eliminated Broker & agent commissions lost
PBM gross profit (rebates, spread, fees) pbmGrossProfit	$28B	estimatelow confidence	PBM gross profit lost
Earnings multiple for capitalizing lost profit (low) insurerEquityMultipleLow	10×	estimatelow confidence	Insurer shareholder value at risk
Earnings multiple for capitalizing lost profit (high) insurerEquityMultipleHigh	17×	estimatelow confidence	Insurer shareholder value at risk
Manufacturer share of retail drug price reductions pharmaManufacturerShare	75%	estimatelow confidence	Pharmaceutical manufacturer revenue

Workforce investment (recurring)

Input	Value	Kind	Used in
Annual cost per residency position residencyCostPerSlot Sources: AAMC (2024)	$150,000	estimatemedium confidence	Workforce capacity investment
New nursing faculty positions funded nursingFaculty Sources: HRSA National Center for Health Workforce Analysis (2024)	10,000	policyhigh confidence	Workforce capacity investment
Annual cost per nursing faculty position nursingFacultyCost	$120,000	estimatemedium confidence	Workforce capacity investment
Funded nursing clinical placements per year clinicalPlacements	60,000	policyhigh confidence	Workforce capacity investment
Cost per clinical placement clinicalPlacementCost	$30,000	estimatemedium confidence	Workforce capacity investment
Students on tuition-free service scholarships at any time serviceScholars	32,000	policyhigh confidence	Workforce capacity investment
Annual tuition + stipend per service scholar serviceScholarCost	$125,000	estimatemedium confidence	Workforce capacity investment
Community health workers funded communityHealthWorkers	60,000	policyhigh confidence	Workforce capacity investment
Annual loaded cost per community health worker chwCost	$48,333	estimatemedium confidence	Workforce capacity investment

One-time: IT systems

Input	Value	Kind	Used in
Extend & re-platform Medicare shared claims systems (FISS, MCS, CWF) itClaimsExtension Sources: GAO (2014)	$6B	estimatemedium confidence	Claims, enrollment & provider systems (IT)
Claims-processing regions (MAC contracts) itMacRegions	10	policyhigh confidence	Claims, enrollment & provider systems (IT)
Scale-up cost per MAC region itMacScaleUp	$0.4B	estimatemedium confidence	Claims, enrollment & provider systems (IT)
Real-time eligibility API & provider portal itEligibilityApi	$1.5B	estimatemedium confidence	Claims, enrollment & provider systems (IT)
Hospital global-budget payment & encounter-data system itGlobalBudgetRails	$1.5B	estimatemedium confidence	Claims, enrollment & provider systems (IT)
New claim types: dental, vision, hearing, HCBS itNewClaimTypes	$1B	estimatemedium confidence	Claims, enrollment & provider systems (IT)
Independent verification, load and parallel testing itVerification	$1B	estimatemedium confidence	Claims, enrollment & provider systems (IT)
Cybersecurity, geographic redundancy, offline interim-payment system itSecurity	$2B	estimatemedium confidence	Claims, enrollment & provider systems (IT)
Legacy system decommissioning & data migration itDecommission	$1B	estimatemedium confidence	Claims, enrollment & provider systems (IT)

One-time: agency start-up

Input	Value	Kind	Used in
UHA staff hired ahead of steady-state funding agencyStaff	40,000	estimatemedium confidence	Agency start-up before steady-state funding
Loaded annual cost per UHA employee agencyLoadedCost	$110,000	estimatemedium confidence	Agency start-up before steady-state funding
Average years each hire is funded before steady state agencyPreFundedYears	1.75 years	estimatemedium confidence	Agency start-up before steady-state funding
Regional offices regionalOffices	10	policyhigh confidence	Agency start-up before steady-state funding
Set-up cost per regional office regionalOfficeSetup	$80,000,000	estimatemedium confidence	Agency start-up before steady-state funding
Rates Board, HTA Institute & Patient Advocacy start-up boardsStartup	$0.5B	estimatemedium confidence	Agency start-up before steady-state funding

One-time: enrollment & outreach

Input	Value	Kind	Used in
Cost per health card (production + mailing) cardCost	$3	estimatemedium confidence	Enrollment, health cards & outreach
Notices mailed per household across waves noticesPerHousehold	3	policyhigh confidence	Enrollment, health cards & outreach
Cost per mailed notice noticeCost	$1.5	estimatemedium confidence	Enrollment, health cards & outreach
Multilingual outreach campaign outreachCampaign	$1.2B	estimatemedium confidence	Enrollment, health cards & outreach
In-person enrollment assisters assisters	5,000	policyhigh confidence	Enrollment, health cards & outreach
Loaded annual cost per assister assisterCost	$70,000	estimatemedium confidence	Enrollment, health cards & outreach
Years assisters are funded assisterYears	3.4 years	policyhigh confidence	Enrollment, health cards & outreach

One-time: hospital transition fund

Input	Value	Kind	Used in
Hospitals with revenue shortfall above 5% under UHP rates hfHospitals Sources: RAND Corporation (2024)	900	estimatelow confidence	Hospital Transition Fund
Average annual net patient revenue of those hospitals hfAvgRevenue	$250,000,000	estimatelow confidence	Hospital Transition Fund
Average shortfall beyond the 5% threshold hfShortfall	10%	estimatelow confidence	Hospital Transition Fund
Share of shortfall covered, Year 1 hfTaper1	75%	policyhigh confidence	Hospital Transition Fund
Share of shortfall covered, Year 2 hfTaper2	50%	policyhigh confidence	Hospital Transition Fund
Share of shortfall covered, Year 3 hfTaper3	30%	policyhigh confidence	Hospital Transition Fund
Share of shortfall covered, Year 4 hfTaper4	15%	policyhigh confidence	Hospital Transition Fund

One-time: rural & safety-net capital

Input	Value	Kind	Used in
Rural hospitals at risk of closure rcRuralHospitals	700	datamedium confidence	Rural & safety-net capital fund
Average repair/replacement grant per rural hospital rcRuralCost	$20,000,000	estimatemedium confidence	Rural & safety-net capital fund
Federally qualified health center sites upgraded rcFqhcSites	1,500	policyhigh confidence	Rural & safety-net capital fund
Average grant per FQHC site rcFqhcCost	$4,000,000	estimatemedium confidence	Rural & safety-net capital fund

One-time: capacity expansion

Input	Value	Kind	Used in
New or expanded community health center sites capChcSites	1,000	policyhigh confidence	Capacity expansion in shortage areas
Cost per community health center site capChcCost	$8,000,000	estimatemedium confidence	Capacity expansion in shortage areas
Ambulatory surgery & imaging centers in shortage areas capAscImaging	400	policyhigh confidence	Capacity expansion in shortage areas
Cost per surgery/imaging center capAscCost	$25,000,000	estimatemedium confidence	Capacity expansion in shortage areas
Dental clinics (operatories) added capDental	2,500	policyhigh confidence	Capacity expansion in shortage areas
Cost per dental clinic capDentalCost	$2,000,000	estimatemedium confidence	Capacity expansion in shortage areas
Behavioral-health crisis & residential facilities capBehavioral	350	policyhigh confidence	Capacity expansion in shortage areas
Cost per behavioral-health facility capBehavioralCost	$20,000,000	estimatemedium confidence	Capacity expansion in shortage areas

One-time: parallel legacy systems

Input	Value	Kind	Used in
State Medicaid systems run in parallel dsStates	50	datahigh confidence	Running legacy Medicaid, Marketplace & Medicare systems in parallel State Medicaid agency wind-down
Average annual cost per state Medicaid system kept running dsStateAnnual	$40,000,000	estimatemedium confidence	Running legacy Medicaid, Marketplace & Medicare systems in parallel
Years run in parallel dsYears	3 years	policyhigh confidence	Running legacy Medicaid, Marketplace & Medicare systems in parallel
Annual cost of federal + state exchanges dsMarketplaceAnnual	$1.5B	estimatemedium confidence	Running legacy Medicaid, Marketplace & Medicare systems in parallel
Medicare legacy systems in parallel dsMedicareLegacy	$1.5B	estimatemedium confidence	Running legacy Medicaid, Marketplace & Medicare systems in parallel

One-time: state Medicaid wind-down

Input	Value	Kind	Used in
State eligibility staff separated or redeployed swStaff	30,000	estimatemedium confidence	State Medicaid agency wind-down
Severance & retraining per staff member swPerStaff	$40,000	estimatemedium confidence	State Medicaid agency wind-down
Decommissioning cost per state system swSystemsPerState	$36,000,000	estimatemedium confidence	State Medicaid agency wind-down
Data migration to UHA swDataMigration	$1B	estimatemedium confidence	State Medicaid agency wind-down

One-time: formulary & HTA start-up

Input	Value	Kind	Used in
Formulary Board & HTA start-up staff fbStaff	400	estimatemedium confidence	Formulary & technology-assessment start-up
Loaded annual cost per staff member fbStaffCost	$150,000	estimatemedium confidence	Formulary & technology-assessment start-up
Start-up years before absorption into admin budget fbYears	4 years	policyhigh confidence	Formulary & technology-assessment start-up
Drug assessments contracted during start-up fbAssessments	500	policyhigh confidence	Formulary & technology-assessment start-up
Cost per contracted assessment fbAssessmentCost	$1,500,000	estimatemedium confidence	Formulary & technology-assessment start-up
International reference-price data & IT fbData	$0.51B	estimatemedium confidence	Formulary & technology-assessment start-up

One-time: evaluation & wait-time registry

Input	Value	Kind	Used in
National wait-time registry build evRegistry	$0.6B	estimatemedium confidence	Independent evaluation & wait-time registry
Patient-experience survey respondents per year evSurveyRespondents	400,000	policyhigh confidence	Independent evaluation & wait-time registry
Cost per survey response evSurveyCost	$100	estimatemedium confidence	Independent evaluation & wait-time registry
Survey years funded from transition budget evSurveyYears	5 years	policyhigh confidence	Independent evaluation & wait-time registry
Contracted independent evaluations evContracts	$0.6B	estimatemedium confidence	Independent evaluation & wait-time registry
Data audits & wait-time measurement validation evDataAudit	$0.6B	estimatemedium confidence	Independent evaluation & wait-time registry

One-time: litigation

Input	Value	Kind
DOJ/HHS attorneys assigned lgAttorneys	300	estimatemedium confidence
Loaded annual cost per attorney lgAttorneyCost	$250,000	estimatemedium confidence
Years of litigation lgYears	5 years	estimatemedium confidence
Outside experts & expert witnesses lgExperts	$0.3B	estimatemedium confidence
Court of Federal Claims §1498 proceedings lgClaimsCourt	$0.325B	estimatemedium confidence

Worker transition program

Input	Value	Kind	Used in
Wage replacement, year 1 of unemployment wpReplacementY1	90%	policyhigh confidence	Worker transition program Worker transition program: full calculation
Wage replacement, year 2 wpReplacementY2	70%	policyhigh confidence	Worker transition program Worker transition program: full calculation
Wage replacement, year 3 wpReplacementY3	50%	policyhigh confidence	Worker transition program Worker transition program: full calculation
Average share still unemployed, year 1 wpUnemployedY1	75%	estimatelow confidence	Worker transition program Worker transition program: full calculation
Average share still unemployed, year 2 wpUnemployedY2	40%	estimatelow confidence	Worker transition program Worker transition program: full calculation
Average share still unemployed, year 3 wpUnemployedY3	25%	estimatelow confidence	Worker transition program Worker transition program: full calculation
Wage replacement cap wpWageCap	$120,000	policyhigh confidence	Worker transition program: full calculation
Wage insurance: share of pay gap covered wpInsuranceShare	50%	policyhigh confidence	Worker transition program Worker transition program: full calculation
Wage insurance duration wpInsuranceYears	2 years	policyhigh confidence	Worker transition program Worker transition program: full calculation
Share reemployed (eventually) wpReemployedShare	75%	estimatelow confidence	Worker transition program Worker transition program: full calculation
Average pay cut when reemployed wpWageLoss	15%	estimatelow confidence	Worker transition program Worker transition program: full calculation
Training voucher wpVoucher	$12,000	policyhigh confidence	Worker transition program Worker transition program: full calculation
Training voucher uptake wpVoucherUptake	60%	estimatemedium confidence	Worker transition program Worker transition program: full calculation
Share of displaced workers aged 58+ wpBridgeShare	12%	estimatemedium confidence	Worker transition program Worker transition program: full calculation
Bridge pension per year wpBridgeAnnual	$35,000	policyhigh confidence	Worker transition program Worker transition program: full calculation
Bridge pension years wpBridgeYears	3 years	policyhigh confidence	Worker transition program Worker transition program: full calculation
UHA & claims-contractor jobs uhaJobs	210,000	estimatemedium confidence	Jobs created: Universal Health Administration & claims contractors
Care coordinators moving to integrated care organizations icoJobs	40,000	estimatelow confidence	Jobs created: Integrated care organization care coordinators
Labor share of incremental clinical spending clinicalLaborShare	55%	estimatemedium confidence	Jobs created: Clinical & direct-care jobs demanded by higher utilization
Average loaded compensation of new clinical jobs clinicalComp	$85,000	estimatemedium confidence	Jobs created: Clinical & direct-care jobs demanded by higher utilization

Employment data (BLS OEWS, May 2025)

Input	Value	Kind
Employment, direct health & medical insurance carriers (NAICS 524114) blsHealthCarriers Sources: Bureau of Labor Statistics (2026)	451,820	datahigh confidence
Mean annual wage, health & medical insurance carriers blsHealthCarriersWage Sources: Bureau of Labor Statistics (2026)	$93,210	datahigh confidence
Employment, other insurance-related activities incl. TPAs & claims adjusting (NAICS 524290) blsOtherInsuranceRelated Sources: Bureau of Labor Statistics (2026)	396,750	datahigh confidence
Health-related share of NAICS 524290 employment tpaHealthShare TPAs for self-insured health plans are a large part of this industry; property & casualty claims adjusting is the rest.	32%	estimatelow confidence
Employment, insurance agencies & brokerages (NAICS 524210) blsAgenciesBrokerages Sources: Bureau of Labor Statistics (2026)	1,004,520	datahigh confidence
Health-insurance share of agency & brokerage employment brokerHealthShare Health is a minority line next to property & casualty and life.	8%	estimatelow confidence
Billing & posting clerks in ambulatory health care (NAICS 621) blsBillingClerksAmbulatory Sources: Bureau of Labor Statistics (2026)	127,200	datahigh confidence
Billing & posting clerks in hospitals (NAICS 622) blsBillingClerksHospitals Sources: Bureau of Labor Statistics (2026)	37,680	datahigh confidence
Medical records specialists (coders), all industries blsMedicalRecords Sources: Bureau of Labor Statistics (2026)	194,720	datahigh confidence
Medical secretaries & front-office staff doing eligibility, prior authorization & collections (full-time equivalent) insuranceFrontOffice A fraction of roughly 800,000 medical secretaries and administrative assistants.	180,000	estimatelow confidence
Mean wage, billing & posting clerks blsBillingClerkWage Sources: Bureau of Labor Statistics (2026)	$51,070	datahigh confidence
Mean wage, medical records specialists blsMedicalRecordsWage Sources: Bureau of Labor Statistics (2026)	$56,790	datahigh confidence

Access & capacity

Input	Value	Kind
Physicians accepting new privately insured patients acceptPrivate Sources: Holgash & Heberlein, Health Affairs Forefront (2019)	96%	datahigh confidence
Physicians accepting new Medicare patients acceptMedicare Sources: Holgash & Heberlein, Health Affairs Forefront (2019)	88%	datahigh confidence
Physicians accepting new Medicaid patients acceptMedicaid Sources: Holgash & Heberlein, Health Affairs Forefront (2019)	74%	datahigh confidence
Psychiatrists accepting new Medicaid patients acceptMedicaidPsych Sources: Holgash & Heberlein, Health Affairs Forefront (2019)	35%	datahigh confidence
Practising doctors per 1,000 people, Canada doctorsPer1000Canada Sources: OECD (2025)	2.7	datahigh confidence
Practising doctors per 1,000 people, United States doctorsPer1000Us Sources: OECD (2025)	2.7	datahigh confidence
Practising doctors per 1,000 people, OECD average doctorsPer1000Oecd Sources: OECD (2025)	3.9	datahigh confidence
Hospital beds per 1,000 people, Canada bedsPer1000Canada Sources: OECD (2025)	2.5	datahigh confidence
Hospital beds per 1,000 people, United States bedsPer1000Us Sources: OECD (2025)	2.8	datahigh confidence
Hospital beds per 1,000 people, OECD average bedsPer1000Oecd Sources: OECD (2025)	4.2	datahigh confidence
Waited 2+ months for a specialist, Canada (2016 survey) specialistWait2moCanada Sources: Commonwealth Fund (2020)	30%	datahigh confidence
Waited 2+ months for a specialist, Norway (2016 survey) specialistWait2moNorway Sources: Commonwealth Fund (2020)	28%	datahigh confidence
Waited 2+ months for a specialist, United States (2016 survey) specialistWait2moUs Sources: Commonwealth Fund (2020)	6%	datahigh confidence
Waited 2+ months for a specialist, Germany (2016 survey) specialistWait2moGermany Sources: Commonwealth Fund (2020)	3%	datahigh confidence
Adults with employer coverage rating their insurance excellent or good (2023) esiRatedGood Sources: KFF (2023)	80%	datahigh confidence
Australians with private hospital cover on top of Medicare (Dec 2024) australiaPrivateHospitalCover Sources: Australian Prudential Regulation Authority (2025)	45.2%	datahigh confidence
Business ownership among male workers just under age 65 businessOwnershipUnder65 Sources: Fairlie, Kapur & Gates (NBER conference paper) (2009)	24.6%	datahigh confidence
Business ownership among male workers just over age 65 (Medicare eligible) businessOwnershipOver65 Sources: Fairlie, Kapur & Gates (NBER conference paper) (2009)	28%	datahigh confidence
Firms with 10 to 24 workers offering health benefits (2025) smallFirmOfferRate Sources: KFF (2026)	51%	datahigh confidence
Firms with 200+ workers offering health benefits (2025) largeFirmOfferRate Sources: KFF (2026)	97%	datahigh confidence
Drop in voluntary job turnover from job lock (Madrian, 1987 data) jobLockTurnoverCut Sources: Madrian, Quarterly Journal of Economics (1994)	25%	datahigh confidence
Drop in adult (20 to 64) mortality after ACA Medicaid expansion medicaidExpansionMortalityCut Sources: Borgschulte & Vogler, Journal of Health Economics (2020)	3.6%	datahigh confidence
Canada median wait, GP referral to treatment (weeks, 2025) canadaMedianWeeks Sources: Fraser Institute (2025)	28.6	datahigh confidence
NHS England waiting list (millions, 2025) nhsWaitlist Sources: NHS England (2025)	7.4	datahigh confidence
NHS England share treated within 18 weeks nhsWithin18 Sources: NHS England (2025)	59%	datahigh confidence