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The rapid emergence of Medicare for All as a mainstream proposal in the Democratic Party has been accompanied by that age-old question which is literally only asked of government programs designed to help poor and working class people: how are we going to pay for it?

The Associated Press reported that the libertarian Mercatus Center, a Koch-funded policy center which is based out of a university whose law school is named after Antonin Scalia, had an answer:

Sen. Bernie Sanders’ “Medicare for all” plan would boost government health spending by $32.6 trillion over 10 years, requiring historic tax hikes, says a study released Monday by a university-based libertarian policy center.

That’s trillion with a “T.”

[...]

The Mercatus analysis estimated the 10-year cost of “Medicare for all” from 2022 to 2031, after an initial phase-in. Its findings are similar to those of several independent studies of Sanders’ 2016 plan. Those studies found increases in federal spending over 10 years that ranged from $24.7 trillion to $34.7 trillion.

Rep. Ro Khanna of California put what this means in the context of our current healthcare costs:

That’s not all. Buried way down at the end of the AP story is this tidbit:

The study found U.S. health care spending under Sanders’ plan would drop over time — about $300 billion lower in 2031.

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That’s right: the AP emphasizes immediately after its lede that trillion has a ‘t,’ but doesn’t think this last point—that the bill would actually reduce our astronomical healthcare costs overall, not to mention the fact that it would cover everyone—merits a mention except as an afterthought near the very end.

Not for nothing, but the AP story was picked up by CBS News, ABC News, Bloomberg, Time, as well as a slew of local outlets—in addition to The Hill, Axios and Fox News, which did their own similar writeups—which means the very scary $32.6 trillion number got sprayed all over the internet with absolutely no context. Love it when the press does the GOP’s work for them.

Matt Bruenig of the People’s Policy Project, a progressive think tank, wrote for Jacobin that the overall reduction in healthcare spending is even larger over the course of ten years:

The report’s methods are pretty straightforward. Blahous starts with current projections about how much the country will spend on health care between 2022 and 2031. From there, he adds the costs associated with higher utilization of medical services and then subtracts the savings from lower administrative costs, lower reimbursements for medical services, and lower drug prices. After this bit of arithmetic, Blahous finds that health expenditures would be lower for every year during the first decade of implementation. The net change across the whole ten-year period is a savings of $2.054 trillion.

When talking about Medicare for All, it is important to distinguish between two concepts: national health expenditures and federal health expenditures. National health expenditures refer to all health spending from any source whether made by private employers, state Medicaid programs, or the federal government. It is national health expenditures that, according to the report, will decline by $2.054 trillion.

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That’s trillion with a “T.”

This is a good example of the uphill battle the left faces in changing the narrative about social programs. Apart from the fact that some reporters are going to take the $32 trillion number at face value and provide absolutely no context for it (which, as we saw in this case, got spread out via other outlets), both political parties have spoken the language of deregulation and government reduction for so long that spending just doesn’t seem to count when people give their money to health insurance companies for a service rather than the government. Pretty funny how that works!