“Medicare for All” has dominated headlines since the 2016 presidential race and is gearing up to be another hot-button topic in the 2020 Democratic primary and presidential election. Much has been said about improved access to care, simplicity of administrative activities, and reduced spending in the American healthcare system that might be expected in a Medicare for All environment. What has not been fully discussed is the potential crippling impact to hospitals’ top-line revenue, which hospitals rely on within an already razor-thin operating margin.