What the facts are

Bernie Sanders, the Vermont senator, said that while his “Medicare for all” health care plan would require tax increases on middle-class families, their overall spending would go down.

What Mr. Sanders said:

“I do think it is appropriate to acknowledge that taxes will go up. They’re going to go up significantly for the wealthy and for virtually everybody, the tax increase they pay will be substantially less than what they were paying for premiums and out-of-pocket expenses.”

This lacks evidence. Mr. Sanders’s health care plan would substantially increase the amount that the federal government spends. Estimates of its precise cost vary, but according to an estimate from the conservative Mercatus Center, which Mr. Sanders has mentioned approvingly, federal spending would need to increase by about 10 percent of the country’s gross domestic product, triple what the government spends on the military. But under Medicare for all, Americans who currently pay health insurance premiums or pay directly when they go to the doctor or pharmacy would be relieved of those costs. For most American families, that would be a substantial savings.

But that does not mean that “virtually everybody” would end up paying less over all. Mr. Sanders has suggested various possible tax increases that could pay for this expansion, including a payroll tax that would affect workers across the economic spectrum. He has not provided enough details about the mix and magnitude of taxes for economists to measure what sorts of families would be better or worse off under Medicare for all. An Urban Institute analysis of Mr. Sanders’s 2016 health care proposal, which included more tax details, found that the proposed taxes would only pay for about half of the cost of the plan.

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What they’re talking about

Elizabeth Warren, the Massachusetts senator, repeatedly avoided answering a question about whether financing her health care plan would require middle-class tax increases, saying instead that their “costs” would not go up.

What Ms. Warren said:

“I have made clear what my principles are here. And that is costs will go up for the wealthy and for big corporations, and for hard-working middle-class families, costs will go down.”

Ms. Warren has indeed proposed a number of large tax increases on the wealthy and corporations, including a new wealth tax, a corporate profits tax and an expansion of Social Security taxes up the income spectrum. But she has also earmarked close to all of the revenue raised by those taxes to pay for other domestic spending priorities, including free public college tuition and child care subsidies.

A Medicare for all health care program, like the one from Mr. Sanders that Ms. Warren has co-sponsored, would require substantial additional government spending. Ms. Warren would not say who would pay tax increases necessary to fund it. But it may be hard to squeeze that much more money out of the rich and corporations alone, beyond the new taxes she has already suggested. Her language about “costs” does provide the possibility that she would raise middle-class taxes, but ensure that middle-class families would save enough on health care spending to come out ahead.