(CNN) Progressives and Republicans have found something in common amid the raging health care debate: They all love talking about single-payer insurance. 
 
 No, they haven't bridged any of the divides on health care policy, and a Canadian-style single-payer plan -- the left prefers to call it "Medicare for all" -- remains implausible in the current Congress. 
 
 But both sides are beginning to see a political benefit in bringing it up. 
 
 Progressives have long held universal health care as a marquee public policy goal and increasingly see opportunities to push for a radical overhaul as President Donald Trump and Republicans on Capitol Hill face headwinds in their efforts to roll back Obamacare. 
 
 Vermont Sen. Bernie Sanders, an independent, is readying a bill proposing a single-payer system, and is expected to file it once the Senate finishes considering the GOP effort to repeal and replace former President Barack Obama's signature law. And more Democratic senators are publicly endorsing such a system. 
 
 Last week, New York Sen. Kirsten Gillibrand, who began her career as a moderate "Blue Dog" member of the House, backed single-payer. Massachusetts Sen. Elizabeth Warren, meanwhile, told The Wall Street Journal, "now it's time for the next step. And the next step is single-payer." 
 
 For Republicans, the calculation is different, but simple: Obamacare is politically more popular than the legislation Republican leadership is pushing on Capitol Hill. The danger of undercutting many of its provisions, including barring insurance companies from rejecting customers or hiking rates due to pre-existing conditions, is clear. For senators from states that accepted and have benefited from Medicaid expansion under the law, the vote is even trickier. 
 
 But single-payer health insurance, or "Medicare for all," is a much more divisive proposition. A recent Pew Research Center poll found that while 52% of Democrats support it, that number drops to 33% when the field expands to include Republicans. 
 
 In the White House and on Capitol Hill, GOP officials are now floating the prospect of a single-payer future -- rather than the survival of Obamacare -- as the likely alternative to a successful repeal process. 
 
 "If we have to negotiate with Chuck Schumer and the Democrats, we're going to be looking down the barrel of a single-payer system because that's what they want to see happen," Sen. John Thune, R-South Dakota, said on "Fox News Sunday." 
 
 Trump's deputy press secretary Sarah Huckabee Sanders brought up single-payer health insurance -- without being asked -- at the White House press briefing on Thursday. 
 
 "The other bill out there that's gained the support of a majority of House Democrats is the Bernie Sanders single-payer plan that would cost the government $32 trillion over the next decades. One hundred and thirteen House Democrats, including the DNC vice chair, have signed on to this approach," she said, referring to Rep. Keith Ellison of Minnesota, the deputy chairman of the Democratic National Committee. 
 
 "The President believes that it's completely unaffordable and creates a one-size-fits-all government approach to health care," she said. "That bill and others like it on the other side that have been proposed are clearly deal-breakers." 
 
 Progressives are also seeking to make use of Obamacare's rising popularity -- and the threat of its undoing. After years spent criticizing the law from the left, they have rallied to protect it in the face of repeal. 
 
 "Right now the goal is defeat this terrible piece of (Republican) legislation and then regroup and go forward doing what every other major country on Earth does and (pass) Medicare for all," Sanders told CNN last week. Days earlier, he and organizers from MoveOn.org, the liberal advocacy group, were barnstorming Pennsylvania, Ohio and West Virginia, rallying opposition to the GOP bill. 
 
 But even as Sanders railed against Trump, tallied Obamacare's achievements and warned about the dangers facing those who might lose coverage, the mention of "Medicare for all" still triggered the heartiest outpouring of applause at already boisterous events. 
 
 "If Democrats retake power, the idea of a public option and Medicare for all are going to be a much easier sell because they stood shoulder-to-shoulder in the fight today," MoveOn's Washington director, Ben Wikler, said as protests swirled on Capitol Hill ahead of the July 4 recess. 
 
 The real test, though, will come when Sanders releases his new single-ayer bill later in the summer. 
 
 The 2011 edition had zero co-sponsors . This new legislation figures to arrive with more support from Democrats, including potential 2020 hopefuls like Gillibrand and Warren, and to greater fanfare from Republicans, who sense both opportunity and danger. 
 
 In both cases, the one sure bet is that both sides will be eager to chat about it. ||||| Throughout his insurgent campaign for the Democratic presidential nomination in 2016, one of Bernie Sanders’s chief rallying points was to question why the United States is the “only major country on Earth not to guarantee health care to all people.” Having taken the issue into the political mainstream, the independent senator from Vermont is turning his broad idea into something more concrete by rolling out a “Medicare for All” bill on the floor of the Senate on Wednesday. 
 
 Related: If Bernie Sanders wants to win 2020 election, he needs to control his supporters, Democrats say 
 
 Even Sanders has acknowledged that it’s “obvious” the bill has no chance of passing with the Senate (and House) controlled by Republicans. But he has already succeeded in pushing the issue further into the spotlight and pressuring Democrats to jump on board. Support for the bill has become a practical litmus test for the party’s 2020 presidential hopefuls. 
 
 After California Senator Kamala Harris signed last month, other potential 2020 candidates—Senators Cory Booker, Elizabeth Warren and Kirsten Gillibrand—were among those to take the number of bill co-sponsors to 11 as of Tuesday afternoon. 
 
 The simple tenant of the proposal is to put in place in the U.S. a single-payer system akin to that used in the U.K., France, Australia, Canada and others. These can differ from fully government-run national health services, as in the U.K., to France’s public/private hybrid. Whatever route they take, though, they offer universal health care and no requirement to get insurance through an employer. In the U.S., the current Medicare safety net, which now covers only people over age 65, would apply to all Americans. 
 
 “Health care must be recognized as a right, not a privilege,” Sanders argues. “Every man, woman and child in our country should be able to access the health care they need regardless of their income. The only long-term solution to America’s health care crisis is a single-payer national health care program.” 
 
 Sanders has said that the plan would in large part be paid for by a progressive tax system that would have the richest households paying more income, capital gains and estate taxes, among others. Existing health care expenditures would also go toward the plan. According to Sanders, his plan would save the American people and businesses $6 trillion over the next decade. 
 
 While there is widespread evidence to support the notion that a single-payer system is far more cost-effective than the current model in the United States, the exact savings under Sanders’s plan remains a topic for much debate. 
 
 Still, although Republicans and even more moderate Democrats aren’t rushing to sign onto a single-payer system anytime soon, polls have showed that Americans have already moved in that direction. A June 2017 Pew Research Center survey found that 60 percent of Americans said the federal government should be responsible for ensuring health care coverage for all Americans. 
 
 Update: An earlier version of this story misspelled the name of Kirsten Gillibrand. This has been corrected. ||||| It's no secret that the cost of failure in the GOP healthcare reform effort will be that Obamacare remains on the books indefinitely. 
 
 Last week, Senate Majority Leader Mitch McConnell hinted that he might be willing to pay that cost. He said that Republicans would work with Democrats to produce a bill that would "fix" Obamacare's exchanges if they're unable to agree on a repeal-and-replace plan. 
 
 But if Sen. Bernie Sanders, I-Vt., is to be believed, the stakes may be even higher. In an interview out last week, Sanders said that he would be waiting in the wings with a single-payer proposal of his own, if the Senate GOP's healthcare reform bid falls apart. 
 
 Single-payer systems have endangered lives and reduced access to quality care everywhere they've been implemented. If Republicans needed any additional motivation for repealing and replacing Obamacare, Sanders's single-payer threat ought to do the trick. 
 
 Proponents of single-payer assume that patients would be better off if government bureaucrats controlled all of our nation's healthcare resources. They'd ensure that everyone had insurance coverage. They'd dictate spending levels and pay healthcare providers. And they'd eliminate all the supposedly wasteful spending that insurance companies devote to administration and marketing. 
 
 That would be a herculean task. Health care amounts to one-sixth of the U.S. economy. Managing it without the aid of market mechanisms like price signals would require bureaucrats to properly allocate trillions of dollars in resources and the labor of millions of American workers. Indeed, the estimated cost of the single-payer proposal Sanders offered in the 2016 election campaign was a whopping $32 trillion over 10 years. 
 
 It's far easier to just declare a global budget for health spending, and then ration care to ensure that spending stays below that ceiling. That's exactly what every other single-payer system does -- and how nations with single-payer systems can keep health spending lower than the United States does. ||||| Democrats are increasingly committing to support single-payer healthcare, amid Republican attacks on ObamaCare and pressure from their party’s left-wing base. 
 
 What was once considered only a progressive talking point has gained traction as more Democratic candidates have been willing to embrace government-funded healthcare on the campaign trail and more House members have been signing onto the idea. 
 
 Single-payer isn’t just being discussed in liberal enclaves of the country like California, where a single-payer measure recently fell short in the state Assembly. It’s a hot topic in Speaker Paul Ryan Paul Davis RyanOvernight Health Care: Trump calls for crackdown on surprise medical bills | Trump officials give religious exemption to foster care program | Uninsured rate at highest level since 2014 | Juul hires former Harry Reid chief of staff As new Congress begins, federal-state connections are as important as ever Trump once asked Paul Ryan why he couldn’t be ‘loyal': book MORE’s (R-Wis.) Republican-leaning district, where all the Democratic candidates running in the primary have supported it. 
 
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 The idea hasn’t won universal appeal in the party, but the spotlight has been shone on the concept of a government-run healthcare system as concerns mount over the Senate GOP’s plan to repeal and replace ObamaCare, which would lead to 22 million more Americans without insurance. 
 
 Sen. Bernie Sanders Bernard (Bernie) SandersSanders poised to announce presidential campaign: report On The Money: Trump agrees to end shutdown without wall funding | Senate quickly clears short-term funding measure | House to vote tonight | Federal workers could get back pay within days | Dems take victory lap Shutdown ends without funding for Trump’s border wall MORE (I-Vt.) championed the idea of universal healthcare during his insurgent presidential campaign, and he’ll introduce his single-payer plan once the debate over ObamaCare ends. 
 
 Other senators — such as Elizabeth Warren Elizabeth Ann WarrenSen. Warren misses the mark on the living wage debate RNC votes to give Trump 'undivided support' ahead of 2020 A crowded 2020 presidential primary field calls for ranked choice voting MORE (D-Mass.) and Kirsten Gillibrand Kirsten Elizabeth GillibrandRNC votes to give Trump 'undivided support' ahead of 2020 Hickenlooper 'leaning' toward joining 2020 race in next few weeks Poll: Biden leads among Dems in 2020 primary field MORE (D-N.Y.), two potential 2020 contenders — are getting on board with a Medicare for All proposal. Sen. Tammy Baldwin Tammy Suzanne BaldwinWhy does the bankruptcy code discriminate against disabled veterans? 116th Congress breaks records for women, minority lawmakers Kyrsten Sinema swears in to Congress using copy of Constitution instead of religious book MORE (D-Wis.), who faces a tough reelection in a state won by President Trump, said she’s a “maybe” on Sanders’s plan but “anticipates” supporting it, according to The Capital Times. 
 
 In the House, Rep. John Conyers Jr.’s (D-Mich.) Medicare for All bill has already netted 113 co-sponsors — nearly double the number of co-sponsors the legislation garnered last congressional session. 
 
 Key names are noticeably absent from the list, including House Minority Leader Nancy Pelosi (D-Calif.) and Minority Whip Steny Hoyer (D-Md.). But other members of leadership, including Democratic Caucus Chairman Joseph Crowley (D-N.Y.) and Assistant Democratic Leader James Clyburn (D-S.C.), are co-sponsors of the bill. 
 
 “It’s nice to see many senators … and a variety of people in the House publicly stating for the first time on record that a single-payer system is the way of the future that we need to be working toward,” Shannon Jackson, the executive director of the Sanders-aligned group Our Revolution, told The Hill. 
 
 Warren has publicly encouraged Democratic candidates to campaign on the idea in 2018 and 2020. But even though the Democrats in Ryan’s likely safe GOP district are supporting it, other Democratic candidates in red states and districts have been more cautious about endorsing single-payer. Rob Quist, the Montana Democrat endorsed by Sanders, was the only candidate in this year’s House special elections to run on that platform. 
 
 “I think that the politicians who choose to run on a campaign that states and embodies that pillar of our platform will be successful and they will be able to connect with the people,” Jackson said. 
 
 A Kaiser Family Foundation poll shows a modest increase in Americans’ support for the concept, with 53 percent of the public supporting all Americans getting their coverage through a single government plan. 
 
 That’s up from 2008 and 2009, when about 46 percent of the public held this position. A majority of the uptick in support has come from independents, Kaiser noted. 
 
 But in practice, Democrats haven’t been able to muster enough votes to pass a single-payer plan. In California’s state Assembly, moderate and progressive Democrats couldn’t agree on the proposal. While it passed the state Senate, California Assembly Speaker Anthony Rendon (D) ultimately tabled the proposal in his chamber. 
 
 “It’ll tend to be an issue that more left-leaning Democrats are willing to embrace,” said Dan Mendelson, president of consulting firm Avalere Health. 
 
 “In order to embrace that concept, you’ll have to be willing to defend the efficiency and effectiveness of a fully run government system, and there are many Democrats who are not going to do that and there are some who are.” 
 
 For Democrats, the increased talk about single-payer offers an alternative message to oppose the Senate GOP’s bill to repeal and replace ObamaCare, he said. 
 
 Under a single-payer system, all Americans would have health coverage, whereas the nonpartisan Congressional Budget Office estimates 22 million people would become uninsured under the Senate GOP’s healthcare plan. 
 
 “I think what you see is the Democrats on the Hill are searching for a single unifying message to unite in opposition to what is happening presently in the Congress,” Mendelson said. “And that’s really what they're looking for.” 
 
 Republicans have taken note, seizing on Warren’s request for Democrats to campaign on single-payer in an attempt to play offense in the healthcare debate as Republicans struggle with their unpopular plan. 
 
 But Republicans are seeing an advantage in Democrats’ embrace of single-payer, too. The National Republican Senatorial Committee (NRSC) is running auto-play Facebook ads that seek to tie the 10 Democratic senators up for reelection in states Trump won to Warren and government-run healthcare. 
 
 The Senate GOP’s campaign arm and the Republican National Committee have pointed to studies that say Medicare for All could cost as much as $32 trillion over a decade. 
 
 “I think that the idea that this is becoming our central focus is mistaken and one that our opponents are trying to put forward so they don’t have to talk about their age tax,” said a Democratic strategist with ties to Senate races. “What unites Senate Democrats is opposition to this disaster of a Republican bill.” 
 
 Some Republicans don’t see single-payer becoming a toxic issue for Democrats, arguing that those kinds of attacks are more of a “deflection tool” from the GOP’s own healthcare bill. 
 
 “It almost seems like it’s too wonky and not enough red meat to really make something catch fire,” a Republican operative in Washington told The Hill. “It’s hard to attack Democrats over single-payer healthcare when we can’t get our act together on repealing ObamaCare.” 
 
 Despite increasing talk of single-payer, Democrats haven’t agreed yet on a healthcare message for the 2018 midterms, in part because that will depend on whether Republicans manage to repeal ObamaCare. 
 
 "The [GOP] Senate bill is almost designed to make healthcare top-tier issue in the next elections,” said Larry Levitt, a Kaiser Family Foundation senior vice president. 
 
 “If the repeal and the replace bill is enacted and signed into law, Democrats will face a challenge as to what their healthcare message will be in 2018 and 2020,” Levitt said, adding that “it’s very likely that many Democrats would turn to single-payer as the next step.” ||||| Bernie Sanders’ single-payer health care plan has won over most other liberal senators, including many weighing 2020 bids. 
 
 The rest of the Democratic Party is another matter. 
 
 Story Continued Below 
 
 As Sanders prepares to unveil his Medicare for All legislation on Wednesday, most of the party’s congressional leaders and vulnerable Senate incumbents are steering clear. Even as the left celebrates Sanders’ ability to push the Democratic agenda leftward after his primary challenge to Hillary Clinton last year, that success appears to have its limits. 
 
 Senate Minority Leader Chuck Schumer told reporters that he would be “looking at all of” the party’s “many good” proposals to expand health care access, but declined to back Sanders. House Minority Leader Nancy Pelosi declared that her priority is shielding Obamacare from a GOP repeal push that’s not yet dead for good. 
 
 Connecticut Sen. Chris Murphy, one of the few Democrats subject to 2020 speculation who has not signed on to the Sanders bill, warned against letting the party’s attention slip to “longer-term health care policy” while the future of the Affordable Care Act remains up for debate. 
 
 “I think the risk is that we get distracted,” Murphy told reporters. “September’s not done. They can still ram through a repeal bill.” 
 
 Wisconsin Sen. Tammy Baldwin on Tuesday became the single-payer bill’s first supporter from the class of Senate Democrats up for reelection next year in states Trump carried. But other politically imperiled incumbent Democrats have said no to Sanders. 
 
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 Sen. Claire McCaskill said in a brief interview that lawmakers have more work to do to keep health care costs in check “before we would think about expanding that [Medicare] system to everyone.” 
 
 Single-payer on a national level would have “a lot of problems,” McCaskill added, although she came out in support of allowing individuals as young as 55 to buy into Medicare. That idea is also backed by Baldwin and two other red-state Democrats up for reelection next year who are declining to endorse Sanders’ bill: Sens. Sherrod Brown of Ohio and Debbie Stabenow of Michigan. 
 
 Stabenow, also a member of Democratic leadership, said Tuesday that she would keep working on her Medicare-at-55 plan “because I think there is some bipartisan interest in that.” She said the party’s first order of business should be shoring up the Obamacare markets, followed by other goals. 
 
 “The first thing has to be to protect the health care people have now and stabilize markets, no question,” Stabenow said. “But we need to focus on lowering the cost of prescription drugs and providing more health care, more health care options.” 
 
 Improving the Affordable Care Act is the core of a bipartisan effort in the Senate health committee. The panel's ranking member, Sen. Patty Murray of Washington, a member of the Democratic leadership, also declined to endorse Sanders’ bill on Tuesday. 
 
 “There’s a lot of Democratic ideas out there, and I haven’t had the chance to look at all of them,” Murray said, adding that she remains “very focused” on the committee’s work. 
 
 Republicans have already seized on the high costs of imposing a single-payer system — which Sanders’ presidential campaign proposed to pay for with new taxes on employers and wealthy individuals — to hammer Democrats for supporting the idea. The National Republican Senatorial Committee criticized Baldwin on Tuesday for backing “the left’s radical plans for government-run health care.” 
 
 Sen. John Barrasso (R-Wyo.), a member of GOP leadership, also reminded reporters Tuesday that Sanders’ home state of Vermont had to back away from its own single-payer health proposal after the economic burden proved too onerous. 
 
 Backers of the Sanders bill acknowledge that single-payer is a heavy political lift but describe it as an important benchmark for Democrats’ future. As the party hones its identity beyond opposition to Trump’s agenda, single-payer fans see enough room to set big long-term goals while waging the shorter-term battle to protect Obamacare. 
 
 “There’s nothing about the politics of the moment or the Affordable Care Act that in any way precludes supporting Medicare-for-all as the ultimate goal, and there’s a clear path to it,” said Sen. Richard Blumenthal. The Connecticut Democrat signed on to the bill Tuesday. 
 
 Sen. Al Franken (D-Minn.), who has been mentioned as a possible 2020 candidate, also expects to sign on to the single-payer bill, a spokesman said Tuesday. Franken noted that his cosponsorship reflects the bill's status as a long-term goal while the party continues short-term work on Obamacare. 
 
 "This bill is aspirational, and I’m hopeful that it can serve as a starting point for where we need to go as a country," Franken said in a statement. "In the short term, however, I strongly believe we must pursue bipartisan policies that improve our current health care system for all Americans — and that’s exactly what we’re doing right now in the Senate Health Committee, on which both Senator Sanders and I sit." 
 
 For other Democrats, however, the idea’s time may have not yet come. 
 
 Ben Cardin said in an interview that he supports universal health coverage but has "certain concerns" about using single-payer to achieve that goal. 
 
 “There’s the political issue, but there’s also the issue about how you make sure there will be adequate resources put into health care,” the Maryland Democrat said. 
 
 Sen. Joe Manchin of West Virginia, a member of leadership who's among the GOP's top targets in 2018, walked a fine line Tuesday as Republicans revived his past comments welcoming a discussion of a government-run health care system. 
 
 "I am skeptical that single-payer is the right solution, but I believe that the Senate should carefully consider all of the options through regular order so that we can fully understand the impacts of these ideas on both our people and our economy," Manchin said in a statement on Tuesday. 
 
 Sen. Dianne Feinstein, facing consternation from liberals in her home state of California — where an effort to enact single-payer statewide ran aground this year — said that she would want to see the price tag before taking a position on Sanders' bill. 
 
 "My understanding is, the cost of single-payer is enormous," Feinstein said, noting that she supports a public option for health insurance outside the private market. 
 
 Murphy and Hawaii Sen. Brian Schatz have offered their own ideas to shift the party's health care debate leftward without going as far as Sanders' plan would. The Connecticut Democrat is working on legislation creating a Medicare buy-in for all individuals and businesses, while Schatz told POLITICO he expects to release a Medicaid buy-in proposal later this month. 
 
 Murphy said he would not sign on to Sanders' bill before its release, urging "our party to take some time and look at all the options available to us before we decide on one unitary route." 
 
 And even as some Sanders-aligned activists spook Democrats with talk of possible primary challenges to candidates who don't support the single-payer plan, other liberals were content to cheer the Vermont independent for attracting more than one-quarter of the caucus to his legislation. Progressive Change Campaign Committee co-founder Adam Green, who worked with Murphy on the Medicare buy-in plan, said that "Democrats are increasingly wrapping themselves in the flag of" Medicare for all without closing off other options that advance the ball. 
 
 "This is how big ideas like expanding Social Security and debt-free college were moved into the mainstream — the North Star gets put up, solid organizing is done, critical mass is built in Congress and on the campaign trail, and party consensus falls into place," Green said by email. "It's happening now." ||||| Sen. Bernie Sanders (I-VT) will release a proposal Wednesday afternoon to transition the United States to a single-payer health care system, one where a single government-run plan provides insurance coverage to all Americans. 
 
 The Sanders plan envisions a future in which all Americans have health coverage and pay nothing out of pocket when they visit the doctor. His plan, the Medicare for All Act, describes a benefit package that is more generous than what other single-payer countries, like Canada, currently offer their residents. 
 
 The Sanders plan goes into great detail about the type of coverage Americans would receive. But it provides no information on how it would finance such a generous health care system. Americans’ taxes would have to change to pay for this kind of proposal. But it’s impossible to tell who would pay significantly more for their coverage and who would pay less, and by how much. This is a crucial part of any health care plan, and in the Sanders proposal, it is notably absent. 
 
 So while the plan would certainly move the American uninsured rate from around 8.8 percent to nearly zero in theory, it’s impossible to tell what it would take to get there and what the bigger economic picture would look like if we did. 
 
 The Sanders bill includes an exceptionally generous benefit package 
 
 Sanders’s single-payer proposal would create a universal Medicare program that covers all American residents in one government-run health plan. 
 
 It would bar employers from offering separate plans that compete with this new, government-run option. It would sunset Medicare and Medicaid, transitioning their enrollees into the new universal plan. It would, however, allow two existing health systems to continue to operate as they do now: the Veterans Affairs health system and the Indian Health Services. 
 
 Those who do qualify for the new universal Medicare plan would get four years to transition into the new coverage. In the interim, they would have the option to buy into Medicare or another publicly run option that does not currently exist. 
 
 Eventually, though, they would all end up in the same plan, which includes an especially robust set of benefits. It would cover hospital visits, primary care, medical devices, lab services, maternity care, and prescription drugs as well as vision and dental benefits. 
 
 The plan is significantly more generous than the single-payer plans run by America’s peer countries. The Canadian health care system, for example, does not cover vision or dental care, prescription drugs, rehabilitative services, or home health services. Instead, two-thirds of Canadians take out private insurance policies to cover these benefits. The Netherlands has a similar set of benefits (it also excludes dental and vision care), as does Australia. 
 
 What’s more, the Sanders plan does not subject consumers to any out-of-pocket spending on health aside from prescriptions drugs. This means there would be no charge when you go to the doctor, no copayments when you visit the emergency room. All those services would be covered fully by the universal Medicare plan. 
 
 This too is out of line with international single-payer systems, which often require some payment for seeking most services. Taiwan’s single-payer system charges patients when they visit the doctor or the hospital (although it includes an exemption for low-income patients). In Australia, people pay 15 percent of the cost of their visit with any specialty doctor. 
 
 The Sanders plan is more generous than the plans Americans currently receive at work too. Most employer-sponsored plans last year had a deductible of more than $1,000. It is more generous than the current Medicare program, which covers Americans over 65 and has seniors pay 20 percent of their doctor visit costs even after they meet their deductibles. 
 
 Medicare, employer coverage, and these other countries show that nearly every insurance scheme we’re familiar with covers a smaller set of benefits with more out-of-pocket spending on the part of citizens. Private insurance plans often spring up to fill these gaps (in Canada, for example, vision and dental insurance is often sponsored by employers, much like in the United States). 
 
 The reason they went this way is clear: It’s cheaper to run a health plan with fewer benefits. The plan Sanders proposes has no analogue among the single-payer systems that currently exist. By covering a more comprehensive set of benefits and asking no cost sharing of enrollees, it is likely to cost the government significantly more than programs other countries have adopted. 
 
 Would Sanders’s health plan lower American health spending? It’s hard to tell. 
 
 One of Sanders’s main arguments in favor of his health care bill is that American health spending is out of control and single-payer would rein it in. 
 
 There are certainly policies in the Sanders plan that would reduce American health care spending. For one, moving all Americans on to one health plan would reduce the administrative waste in our health care system in the long run. 
 
 American doctors spend lots of money dealing with insurers because there are thousands of them, each negotiating their own rate with every hospital and doctor. An appendectomy, for example, can cost anywhere from $1,529 to $186,955, depending on how good of a deal an insurer can get from a hospital. 
 
 That doesn’t happen in a single-payer system like the one Sanders proposes. Instead of dealing with dozens of insurers that set hundreds of prices, doctors only need to send bills to the federal government. 
 
 One 2003 article in the New England Journal of Medicine estimates that the United States spends twice as much on administrative costs as Canada. A 2011 study in the journal Health Affairs estimates American doctors spend four times as much dealing with insurance companies compared with Canada. 
 
 A single-payer health plan would have the authority to set one price for each service; an appendectomy, for example, would no longer vary so wildly from one hospital to another. Instead, the Sanders plan envisions using current Medicare rates as the new standard price for medical services in the United States. 
 
 Medicare typically has lower prices than those charged by private insurance plans that cover Americans under 65. This suggests that switching to the Medicare fee schedule would be another policy change that would tug health spending downward. 
 
 But there are forces in the Sanders plan that encourage higher health spending too. Its robust benefit package with no cost sharing would likely lead to more doctor visits and hospital trips. As the classic RAND Health Insurance Experiment found, patients respond to lower cost sharing in health care by seeking more treatment. Some of that treatment is necessary, but other services provided are not. 
 
 And the Sanders bill would actually raise the prices currently paid by Medicaid, which covers about 50 million low-income Americans. Medicaid traditionally pays lower prices than Medicare and private insurance. If these patients were absorbed into the universal Medicare plan, their doctors would be paid more each time they were seen. 
 
 We haven’t seen a Congressional Budget Office score of the Sanders plan yet — and it’s hard to know how these countervailing forces (some pushing health spending up and others forcing it down) would interact with one another to change overall health costs. 
 
 The big question Sanders doesn’t answer: how do you pay for it? 
 
 The Sanders plan goes into great detail on what kind of coverage a universal plan ought to offer. But it does not do any work explaining how to pay for such a generous benefit package. 
 
 A Sanders spokesperson said over email the office would release a set of financing options later Wednesday afternoon. 
 
 “There’s nobody who has all of the answers,” Sanders told my colleague Jeff Stein when asked about the financing of his health plan. “Nobody has all the answers. What I can say is we are going to be listing a number of revenue-raising proposals, which will generate more than enough money to pay for what we want to do.” 
 
 Eventually though, somebody will need to have those answers — and they’re not easy to find. 
 
 Financing the health care system that Sanders envisions is an immense challenge. About half of the countries that attempt to build single-payer systems fail. That’s Harvard health economist William Hsiao’s estimate after working with about 10 governments in the past two decades. Whether he is in Taiwan, Cyprus, or Vermont, the process is roughly the same: Meet with legislators, draw up a plan, write legislation. Only half of those bills actually become law. The part where it collapses is, inevitably, when the country has to pay for it. 
 
 This is what happened when Sanders’s home state of Vermont attempted to create a single-payer plan in 2014. Much like Sanders, local legislators outlined a clear vision of the type of health plan they’d want to extend to all Vermonters. Their plan was arguably less ambitious; it did require patients to pay money when they went to the doctor. 
 
 But Vermont’s single-payer dream fell apart when the state figured out how much it would need to raise taxes to finance its new system. Vermont abandoned the government-run plan after finding it would need to increase payroll taxes by 11.5 percent and income tax by 9 percent. 
 
 It’s true — in Vermont and in the United States — that these increased taxes don’t necessarily mean overall health spending is rising. It’s entirely possible that health spending will go down as taxes go up, with Americans no longer spending billions on premiums for employer-sponsored coverage. 
 
 Single-payer systems change who pays for health care, often shifting more of the burden onto wealthier individuals to create a more progressive system. The proposed 9 percent income tax in Vermont, for example, would be far more expensive for the $100,000 worker than the $30,000 earner. 
 
 But who pays how much more is a key question this Sanders bill doesn’t answer. Until there is a version that does, we can’t know whether the health system the Vermont senator envisions could actually become reality. ||||| A frantic scramble to influence the Senate’s healthcare legislation intensified on Monday, with House conservatives pressuring their allies in the Senate and Democrats mounting a furious public relations blitz to kill the bill. 
 
 The pace of activity is picking up ahead of the informal July 4 deadline set by Senate Majority Leader Mitch McConnell Addison (Mitch) Mitchell McConnellSenate passes 0B defense bill Overnight Health Care: New GOP ObamaCare repeal bill gains momentum Overnight Finance: CBO to release limited analysis of ObamaCare repeal bill | DOJ investigates Equifax stock sales | House weighs tougher rules for banks dealing with North Korea MORE (R-Ky.) for a vote. 
 
 McConnell does not want the ObamaCare debate to eat up more precious legislative time, with nearly half the year gone and congressional Republicans and President Trump still looking for a major legislative victory. 
 
 Senate Republican Policy Committee Chairman John Barrasso John Anthony BarrassoDems force 'Medicare for All' on Americans but exempt themselves GOP sees fresh opening with Dems’ single payer embrace Overnight Health Care: CBO predicts 15 percent ObamaCare premium hike | Trump calls Sanders single-payer plan ‘curse on the US’ | Republican seeks score of Sanders’s bill MORE (Wyo.) told reporters that he expects a Senate vote on the bill as soon as next week, underlining the importance of the next two weeks. 
 
 McConnell is walking a tightrope in seeking to win over centrists and conservatives for a Senate version of the House-passed American Health Care Act — which is being negotiated entirely behind closed doors. 
 
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 Much of the focus has been on winning over moderates in the 52-member conference, a strategy that risks losing conservative Sens.(R-Ky.),(R-Utah) and(R-Texas). McConnell can only afford two defections, with every Senate Democrat expected to be a “no” vote. 
 
 In an effort to buck up the conservatives, the Republican Study Committee (RSC) — the largest group of conservatives in the House — warned that the Senate risks seeing its bill die in the House if it drifts too far to the center. 
 
 The RSC specifically warned that the bill would lose support in the House if it did not keep four provisions, including the phasing out of extra federal funding for Medicaid in 2020. They also warned McConnell against preserving ObamaCare’s tax increases, removing language defunding Planned Parenthood or barring refundable tax credits from being used to “federally fund abortions.” 
 
 In a bid to keep moderate Republicans on board, McConnell has proposed phasing out enhanced federal funding for Medicaid expansion in 2023. 
 
 GOP senators have also discussed keeping ObamaCare taxes to help pay for the costs of the bill, and language on Planned Parenthood in the House bill may be struck down by the Senate parliamentarian. The Senate plans to use special budgetary rules to prevent Democrats from filibustering the healthcare bill, but this makes certain provisions vulnerable under other Senate rules. 
 
 James Wallner, a former aide to Lee and Sen. Pat Toomey (R-Pa.), who are both playing active roles in the healthcare talks, said the RSC letter shows that conservatives are laying down their markers before it’s too late. 
 
 “To the extent that the bulk of the party wants to pass the House-passed bill or a modified version of the House-passed bill, individual members need to take steps to give themselves leverage heading into that kind of high-stakes showdown,” he said. 
 
 Senate Democrats are hoping to have an impact, too. They threatened Monday to grind the Senate to a halt to protest Republicans’ decision to craft the bill in private meetings, skipping the regular order of holding hearings and marking it up in public committee sessions. 
 
 “If Republicans won’t relent and debate their healthcare bill in the open for the American people to see, then they shouldn’t expect business as usual in the Senate,” said Senate Democratic Leader Chuck Schumer Charles (Chuck) Ellis SchumerSenate Dems hold floor talk-a-thon against latest ObamaCare repeal bill This week: Senate wrapping up defense bill after amendment fight Cuomo warns Dems against cutting DACA deal with Trump MORE (N.Y.). 
 
 Democrats planned to hold a late-night talk-a-thon on the Senate floor Monday night to put the spotlight on the GOP’s secretive tactics — a strategy Democrats used earlier this year to protest some of Trump’s controversial Cabinet picks. 
 
 The three conservatives are pressing different issues on healthcare. 
 
 Paul has made clear to colleagues that he will not support legislation that creates a new GOP-sponsored entitlement program in the form of refundable tax credits to help low-income people buy private insurance plans. 
 
 Lee and Cruz are pressing GOP leaders to allow states to get out of two major regulatory requirements under ObamaCare. 
 
 One, known as guaranteed issue, mandates that insurance companies sell insurance plans to people regardless of how sick they are, and another, known as community rating, prohibits insurance companies from pricing those plans to reflect the greater financial risk of insuring people with pre-existing medical conditions. 
 
 A GOP source familiar with the negotiations said McConnell has so far refused to promise conservatives to let states opt out of the community rating requirement — which keeps health plans more affordable for sick people but sends premiums soaring — or to exempt states altogether from the regulatory mandate and allow them to opt in. 
 
 McConnell, however, is worried that if he effectively guts ObamaCare’s popular prohibition against insurers charging higher prices for sick people, he would lose moderate votes. 
 
 Conservatives are stepping up their efforts to mold the bill, as it’s become apparent that Trump is primarily interested in a political victory and is willing to cater to moderates to get one. 
 
 At a meeting at the White House last week with prominent centrists such as Sens. Lisa Murkowski Lisa Ann MurkowskiSenate Dems hold floor talk-a-thon against latest ObamaCare repeal bill Collins skeptical of new ObamaCare repeal effort How Senate relationships could decide ObamaCare repeal MORE (R-Alaska), Rob Portman Robert (Rob) Jones PortmanWeek ahead in tech: Debate over online sex trafficking bill heats up 'Hillbilly Elegy' author won't run for Senate Brown, Portman urge Trump administration to move quickly on a steel decision MORE (R-Ohio) and Susan Collins Susan Margaret CollinsSenate Dems hold floor talk-a-thon against latest ObamaCare repeal bill Ryan: Graham-Cassidy 'best, last chance' to repeal ObamaCare Collins skeptical of new ObamaCare repeal effort MORE (R-Maine), Trump criticized the House-passed bill as “mean” and urged Senate Republicans to craft legislation that is “generous, kind [and] with heart.” 
 
 “That may be adding additional money into it,” the president said at the start of the meeting. 
 
 Moderate Republicans have sought to put their imprint on the legislation by pushing it further to the center. 
 
 A group led by Portman wants to extend the phase-out of extra federal funding for the Medicaid expansion to 2027 but would likely accept 2025 as a split-the-difference compromise with McConnell’s proposed end date of 2023. 
 
 Murkowski and Collins have also emphasized the importance of preserving funding for Planned Parenthood. 
 
 Murkowski wrote in a recent letter to a constituent that she is committed to providing insurance coverage to people with pre-existing conditions, continuing support for Medicaid expansion and preserving funding for Planned Parenthood. 
 
 — Jordain Carney and Rachel Roubein contributed.
– Senators are back at work Monday, and their No. 1 priority remains trying to craft an alternative to ObamaCare. The problem is that Mitch McConnell's task of getting the necessary 50 votes seems to have gotten only more difficult over the holiday break, and that's raising a slew of stories about what happens if the GOP bill fails. Shoring up ObamaCare is one possibility, but another is the controversial idea of some kind of single-payer system. The long-shot concept, anathema to conservatives, is surfacing more and more in stories: Definition: Under a single-payer system, "doctors and hospitals are mostly private entities, but are paid exclusively by the government," explains a primer at Mother Jones. "Canada is single-payer, with each province acting as the sole source of payment to doctors and hospitals. In the US, Medicaid and traditional Medicare are single-payer." Tax hikes: Everybody would get core coverage regardless of income, job, or health status, explains Money, and people would no longer get insurance through their jobs. But paying for it would surely require new tax increases of some kind. Sanders, and others: The concept is gaining traction among Democrats, reports the Hill. Bernie Sanders promises to introduce a bill when debate ends on the GOP ObamaCare alternative. Sens. Elizabeth Warren and Kirsten Gillibrand back the concept, and in the House, a "Medicare for All" proposal by Rep. John Conyers has 113 co-sponsors. Warren, specifically, told the Wall Street Journal last month that "now it's time for the next step, and the next step is single payer." Please, no: Putting bureaucrats in charge of health care isn't the answer, writes Sally Pipes at Forbes. "Single-payer systems have endangered lives and reduced access to quality care everywhere they've been implemented," she notes, citing "deplorable care" in Britain and Canada and arguing that if Republicans needed any incentive to make progress on their health bill, the prospect of a single-payer system should do it. California: A bill to shift to a single-payer system stalled last month in the California Assembly, and the Los Angeles Times reports that a main reason is that it was "short on key policy specifics—most significantly, how to pay for it." Partisan divide: A Pew Research Center poll finds that 52% of Democrats support the single-payer idea, but the overall percentage in support drops to 33 when Republicans are added, reports CNN. For that reason, both sides seem to love talking about it, notes the story. Senate GOP plan: It's not dead yet, though the positions of conservatives and moderates within the GOP seem to have hardened in the last week, reports Politico. That makes McConnell's quest for a compromise acceptable to enough senators exceedingly difficult.