The promise is clear. The full bill is not yet known.
Complete covered treatment. No deductibles, copays, coinsurance or extra participating-provider bills for covered public-plan care. Premiums are separate.
01 / Two separate comparisons
Useful pieces, not a total to add up.
All amounts below are billions of dollars on the saved 2030 reference basis. They are not a forecast of cash paid in 2030, a launch date or a ten-year budget. The first shows payments already counted in care. The second tests a different group entering public coverage. Do not add the two cases.
Patient payments already included in care
Five selected community groups: work/public coverage overlap, Medicare and Medicaid together without work coverage, Medicare without work coverage, Medicaid without work coverage, and uninsured people. These are modeled coverage groups, not all households or all eligible residents.
What this does not tell us. These payments are already inside the conditional care estimate. Do not add them again. They exclude institutional patient payments and premiums. Ending a patient bill is not the same as net household savings: new taxes, consented premiums, ended premiums and paid refunds must be matched to the same household and year.
Assumptions behind this comparison
The saved 2030 comparison projects the selected historical service and payer records using its population and spending factors. It includes agency home care, additional equipment/medical services and paid-independent home bundles once. It does not establish the clinical share of mixed support bundles or create a new support entitlement.
The evidence download includes exact values, source fields and original result files. Display rounding does not measure accuracy; these are not statistical confidence bounds.
A separate test: the whole work-covered group enters
Employer/union coverage months without Medicare or Medicaid, after the source model's specialist-arrangement exclusions. Includes dependents and retirees, not just workers. The 2030 projection represents 147.561 million annual coverage equivalents, not a forecast of new enrollees. Institutional residents and other-private coverage are outside this group.
What this does not tell us. Not predicted enrollment, a full cost bound or a net federal funding gap. Do not automatically add this case to another subtotal or subtract unmatched all-sector employer credits or premiums. Actual entry could have a different health mix. Remaining benefits, delivery capacity, setup, retained support and matched cash/baseline effects are not fully priced. No staffing savings or provider-return guarantee is assumed.
Assumptions behind this comparison
This exposure test moves the entire modeled group, not a selected take-up rate. It reuses ten service groups, a net-drug spending proxy, service-specific zero-charge demand responses and separate access-demand additions of 2.5% for medical care and 4% for drugs. These additions use the original base, not compounded growth. Gross operations use the inherited care × 0.03 / 0.97 convention, not a validated staffing budget.
The evidence download includes exact values, source fields and original result files. Display rounding does not measure accuracy; these are not statistical confidence bounds.
02 / Material gaps
Three parts of the bill still need work.
Additional care and delivery capacity Unknown
What more is needed to deliver the complete treatment bundle, timely access and adequate local care, beyond work already priced or funded. Existing demand allowances are not proof that all needs are met.
Implementation after reuse Unknown
The net cost of adapting benefits and payment systems, connecting programs, moving coverage safely, testing readiness and closing old contracts. Existing systems are not free to adapt. Do not stack old startup allowances.
Matched cash and shared funding Unknown
Employer credits, collections, household consent, refunds and joint tax receipts for the same people and years, after housing and other platform commitments. The 2029–2038 cash estimate must also include temporary payments and ongoing interest.
These are obligations to estimate, not excluded benefits. Support funded elsewhere must be counted once. The separate mixed-care amount reserved for unresolved costs is not spare funding: matching realized costs reduce that amount. It cannot also pay for startup.
No assumed staffing cuts, guaranteed provider returns or unsupported national savings balance this report. May 2025 wage benchmarks remain separate from the unresolved 2024 comparison; neither closes the delivery-cost gap.
03 / Funding and household effects
A payment rule is not money collected.
Qualifying employer health spending earns a worker-specific credit against the employer's annual obligation. Private spending does not enter the public fund. Annual reconciliation can return public overpayments; unused private spending earns no cash refund. A switch to public coverage does not necessarily pay for itself. Read the adopted settlement rules.
Household premiums require consent. Earlier honest assessments stay protected; final settlement can lower them, not raise them. The receipt-month severance rule counts annual income once. A canceled unpaid bill is not a cash refund. We test funding without incoming household premium cash while keeping refunds owed.
Tax and employer contribution rates remain open. Static tax liabilities and hypothetical contributions are not receipts. The same tax dollar cannot pay for healthcare and housing or another platform promise. Temporary outlays, refunds and ongoing interest belong in the same calendar-year account.
Full plan cost, complete funding gap and net household savings: still unknown. The federal funding guarantee is a promise to fund care, not a new revenue source. The historical portfolio model is not a score of this design.
The download uses the same data as this page and includes the saved analytical results with their original status labels and source fingerprints. It is a record of conditional calculations, not a new estimate or refreshed source dataset.
Transported demand assumptions, not an endorsement, provider fee schedule or estimate of this plan.
The source agencies do not endorse Attractor. Survey coverage, future prices, care mix and selection into public coverage limit these comparisons. Our next analytical work is the missing care/setup estimate and matched cash/funding account, not another sum of unlike subtotals.