Paying for it
The plan: $125 from you, $707 from employers and governments, a ceiling of $832 in total per person per month. And none of it counted twice.
The basic formula
| Who pays | Monthly | Yearly |
|---|---|---|
| You (standard enrollee contribution) | $125 | $1,500 |
| Employer, government or other sources | $707 | $8,484 |
| Total HEALTH5 funding | $832 | $9,984 |
A familiar price. The average 2025 employer plan for one person cost $9,325 a year. Workers paid $1,440 of that, about $120 a month, roughly the same as the proposed $125 contribution (KFF 2025 Employer Health Benefits Survey). HEALTH5 would aim to cover five benefits for close to the price Americans already pay for one.
For workers with an employer contribution, the employee would pay $125 and the employer $707. Employers could keep offering HEALTH5 plans as long as they met the national minimum standard. In the proposal’s rubric, employers with 20 or more employees would help fund the balance. For people without an employer, existing public health funding or other authorized sources would cover the $707. Retirees and people on fixed incomes could have the $125 deducted from retirement or benefit payments.
Run the national numbers
Move the sliders to change the assumptions. The starting values are HEALTH5’s: 340 million people, an $832 monthly ceiling, $125 from each member, and the balance split 50% employers, 35% federal, 15% state and local.
- Total HEALTH5 funding per year
- From members
- Balance to fund
- Employers
- Federal government
- State and local governments
- Below 2024 national spending of $5.263 trillion
The color bar shows members (yellow), employers (green), federal (navy) and state and local (gray). These are illustrations of the proposal’s structure, not forecasts.
Not new spending: redirected spending
The $3.395 trillion would be total system funding, not a new federal bill. Americans already pay for health care through premiums, payroll taxes, Medicare, Medicaid, ACA subsidies and state programs. In 2024 Medicare spent $1.118 trillion, Medicaid $931.7 billion and private health insurance $1.645 trillion (CMS NHE fact sheet). HEALTH5 would redirect those existing dollars.
| Sponsor | Share of $5.26T | Proposed under HEALTH5 |
|---|---|---|
| Households | 28% (about $1.47T) | $125 per person per month |
| Private businesses | 18% | Employers with 20+ workers fund part of the balance |
| Federal government | 31% | Funds part of the balance plus retained programs |
| State and local government | 16% | Funds part of the balance plus retained programs |
The no-double-counting rule. A Medicare, Medicaid, employer or ACA dollar that funded HEALTH5 would have to be credited against the new system. The same dollar can’t be counted once under today’s system and again as new HEALTH5 spending.
What it could mean for a household
Households paid about 28% of national health spending in 2024 (CMS). Spread across 340 million people, that averages roughly $361 per person per month in premiums, out-of-pocket costs and other household health spending.
These are averages across all Americans, not a premium anyone actually pays today. Individual households vary widely.
On a $4,000 monthly paycheck, the employee Medicare payroll tax is 1.45%, or $58 a month (IRS Publication 15). The proposed HEALTH5 contribution would be a flat $125 per person, covering dental, vision, hearing and prescriptions along with medical care.
A real-world benchmark: the Teamsters’ Central States fund
Large pools with one rulebook already exist. The Central States, Southeast and Southwest Areas Health and Welfare Fund is a nonprofit trust that covers UPS Teamsters and other union workers through TeamCare. Its 2024 public filing shows what that model costs (2024 Form 5500 and audited statements).
Under the UPS contract, the company pays the cost into the fund by the hour and week, and the 2023–2028 agreement adds up to $40 a week each year for health and pension combined (UPS National Master Agreement, Article 34). The fund pays medical claims through Blue Cross Blue Shield of Illinois’s network and uses contracted pharmacy, dental and vision managers. It also provides life, accidental death and disability benefits.
| Line item | Total | Per worker |
|---|---|---|
| Employer contributions | $4.540 billion | $19,977 |
| Benefits paid | $3.763 billion | $16,557 |
| Administration and TeamCare fees | $204 million | $897 |
| Reserves at year end | $10.0 billion | about 2.7 years of benefits |
What it shows. A large nonprofit pool ran on about 5% for administration in 2024. Fully insured large-group plans can spend up to 15% on administration and profit under federal rules (CMS). And workers paid almost nothing, because their employers paid the full cost. HEALTH5 would apply the same idea nationally: one large pool, one rulebook, shared funding. Figures are per worker, not per person, because each worker’s coverage includes dependents. The full filing can also be found through the Labor Department’s EFAST2 Form 5500 search.
Sources for this page
- KFF, 2025 Employer Health Benefits SurveyAverage 2025 employer single premium of $9,325 a year, with workers paying $1,440 of it.
- CMS, National Health Expenditure Fact Sheet (2024 data)Total 2024 spending of $5.3 trillion and $15,474 per person; hospital, physician and drug spending; Medicare, Medicaid and private insurance totals; sponsor shares.
- CMS, National Health Expenditures 2024 Highlights (PDF)Sponsor shares: households 28%, private business 18%, federal 31%, state and local 16%.
- IRS Publication 15, Employer's Tax GuideMedicare tax of 1.45% for employees and 1.45% for employers, with no wage-base limit.
- Central States, Southeast and Southwest Areas Health and Welfare Plan, 2024 Form 5500 with audited financial statements (PDF, 77 MB)2024 employer contributions of $4.54 billion, benefits paid of $3.76 billion, administration of $204 million, about 227,000 active participants and 811 employers.
- UPS National Master Agreement 2023–2028 (PDF)Article 34: health and welfare and pension contribution increases, TeamCare coverage and long-term disability benefits.
- CMS, Medical Loss Ratio fact sheetLarge-group insurers must spend at least 85% of premiums on care and quality improvement; small-group and individual at least 80%.
- U.S. Department of Labor, EFAST2 Form 5500 filing systemPublic access to annual reports filed by employee benefit plans.
Policy design details come from the UR2Big HEALTH5 Comprehensive Research and Policy Proposal (November 2026). See all sources.
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