Sanders said he is seeking to replace a “dysfunctional” system based on “greed and profiteering” by health insurance companies.

“Together we are going to end the international embarrassment of the United States of America, our great country, being the only major nation on earth not to guarantee health care to all as a right,” Sanders said. “This is a struggle for the heart and soul of who we are as American people.”

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Republicans and some prominent Democrats have sought to cast Medicare-for-all plans as astronomically costly — some studies have suggested they could increase government spending on health care by more than $25 trillion over a decade. The critics also portray the plans as in­cred­ibly complicated to implement, given the vast array of physicians, hospitals and insurers affected.

Sanders has acknowledged that citizens could pay more in taxes, but he argues that they would ultimately save thousands of dollars a year on out-of-pocket health-care costs. For most families, the higher taxes would be more than offset by what they would save on private premiums and deductibles, Sanders says.

He also argues that his program would curtail overall health-care spending in the United States because the traditional Medicare program spends only 2 percent of its costs on administration, far less than private health insurance companies.

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Sanders’s new bill is similar to past legislation he has introduced but now includes coverage for long-term-care services, benefits that further increase the cost.

Sanders introduced his plan inside a crowded room in the Dirksen Senate Office Building, flanked by activists and medical industry professionals. They stood in front of a blue banner, framed by two U.S. flags, that bore the slogan, “Health care is a right.”

The event underscored how much headway Sanders has made among Democrats in pushing what was viewed as a fringe idea during his last presidential bid.

The party’s eventual 2016 nominee, Hillary Clinton, dismissed Sanders’s vision as impractical, given how difficult it was to pass President Barack Obama’s less ambitious Affordable Care Act in 2010.

This cycle, at least 10 other candidates seeking the Democratic presidential nomination support some version of a single-payer plan, and four of Sanders’s Senate colleagues eyeing the White House — Cory Booker (N.J.), Kirsten Gillibrand (N.Y.), Kamala D. Harris (Calif.) and Elizabeth Warren (Mass.) — have signed on to the bill he is introducing in the chamber.

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Gillibrand offered remarks at Wednesday’s event.

“Medicare-for-all is a dream. It’s called the American Dream,” said Sen. Richard Blumenthal (D-Conn.), who was also there.

Some 2020 Democratic contenders, including former Colorado governor John Hickenlooper, have criticized Sanders’s measure as politically infeasible. Hickenlooper has said that Medicare-for-all should not be “a litmus test of what it takes to be a good Democrat.”

In an attempt to show growing support for the bill, Sanders announced that his latest Medicare-for-all legislation has been endorsed by 63 national organizations and unions — double the number from two years ago.

On Capitol Hill, House Speaker Nancy Pelosi (D-Calif.) is among those who have voiced skepticism about moving to a single-payer system. Democratic leaders have been more focused on preserving the Affordable Care Act amid the Trump administration’s attempts to dismantle it.

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President Trump has pledged to produce new legislation to replace the ACA but has abandoned plans to push for a vote before the 2020 election. In an official statement criticizing the Medicare-for-all proposal, White House press secretary Sarah Sanders said, “The Trump Administration is working on realistic solutions to provide Americans with the options and control they want, the affordability they need, the ease they expect, and the quality they deserve, rather than forcing a government takeover of the healthcare system.”

Even before Sen. Sanders formally unveiled his plan Wednesday, White House officials were attacking it. During an appearance on Fox News, White House counselor Kellyanne Conway called Medicare-for-all “a bad deal for America.”

“This is a government takeover,” she said. “I gave birth four times. I didn’t want Uncle Sam and Big Brother in there with me.”

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Republican lawmakers and advocacy groups piled on after the event.

Sen. John Barrasso (R-Wyo.) released a letter he wrote to the Congressional Budget Office seeking clarity on the exact cost of Sanders’s plan, which he characterized as “a massive amount of spending.”

“Congress must understand the full impact of this proposal, along with the consequences for hospitals, health care providers, and patients,” Barrasso wrote.

The Senate Leadership Fund, a super PAC that seeks to elect more Republicans to the chamber, lambasted Sanders’s plan.

“Bernie Sanders’ plan to destroy the Medicare program and socialize our healthcare is now Democratic Party dogma,” the group’s president, Steven Law, said in a statement. “Democrat Senate candidates can try to hide, but we will make certain voters understand that Democrats are lining up behind abolishing private insurance, ruining Medicare, restricting medical choices, raising taxes on hardworking families, and exploding the deficit.”

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In a statement later Wednesday, Sanders suggested that if he is elected president and Democrats retake control of the Senate, there’s a realistic scenario for his plan to pass.

Sanders cited a provision in Senate rules that allows some legislation to be considered as part of the budget reconciliation process, which requires only a simple majority of the chamber to advance rather than the 60 votes needed to break a filibuster.

“I would remind everyone that the budget reconciliation process, with 51 votes, has been used time and time again to pass major pieces of legislation and that under our Constitution and the rules of the Senate, it is the vice president who determines what is and is not permissible under budget reconciliation,” Sanders said. “I can tell you that a vice president in a Bernie Sanders administration will determine that Medicare for All can pass through the Senate under reconciliation and is not in violation of the rules.”