Rep. Ro Khanna Introduces Legislation to Support State-Based Universal Health Care
Washington, DC – Today, Representative Ro Khanna (CA-17), member of the House Committee on Oversight and Accountability, reintroduced the State-Based Universal Health Care Act. Recognizing the unique position of American states to lead the push for universal health care, Rep. Khanna's bill provides states with federal funding streams and regulatory flexibility to support affordable, universal health care plans.
“Universal health care will save lives and help fix our broken system that has left millions of Americans with crushing medical debt. As we work towards universal health coverage at the federal level, we should also support state-based plans. I'm proud to lead this critical legislation to give every state the power to provide coverage for their residents while we continue working to make Medicare for All a reality,” said Rep. Ro Khanna (CA-17).
The State-Based Universal Health Care Act creates a waiver to allow states to develop their own plans to provide access to health care for all their residents via access to federal funding streams and regulations flexible enough to support affordable, universal health care plans. To apply for the waiver, participating states or groups of states must propose plans to provide health care coverage for 95 percent of their residents within five years.
After that time, participating states would be required to demonstrate they reached coverage targets and provide a plan to cover the remaining five percent of their population. States that do not reach the 95 percent target after five years would have to revise their plan to achieve the targets, or risk losing their waiver. Federal technical assistance would be made available for states seeking help in developing and implementing these plans.
The State-Based Universal Health Care Act also requires benefits provided under state plans be equal to or greater than what federal beneficiaries receive now. An independent panel of health care experts and officials would evaluate whether a state's proposal meets the requirements and would then provide a public recommendation of waiver application approval or rejection to the Secretary of Health and Human Services.
The provided regulatory flexibility and funding streams combined include: (1) the requirements for the establishment, creation, and maintenance of health benefit exchanges; (2) cost-sharing reductions under the ACA; (3) premium tax credit and employer mandate under the ACA; (4) Medicare; (5) Medicaid; (6) CHIP; (7) FEHBP; (8) TRICARE; and (9) ERISA pre-emption provision. States will have the freedom to devise their own individual state-based universal health care programs, as long as they meet the coverage breadth and depth requirements.
“In the wealthiest nation on the planet, no one should be without health care. Universal health care is the lifeline that millions of people need so they don’t have to decide between getting critical medication and putting food on the table, which is why I’m proud to join Representative Khanna in introducing legislation to support state-based universal health care. This is one of many important steps towards making Medicare for All a reality. Health care is a human right, period, and we must make sure our advocacy and our legislation reflect that,” said Representative Jamaal Bowman, Ed.D (NY-16).
“Every American deserves access to quality health care, regardless of their zip code or income level. Giving states the choice to create their own universal health plans isn’t just a practical investment, it’s a moral imperative. This is a step toward ensuring everyone can access quality, affordable and appropriate health care,” said Representative Val Hoyle (OR-4).
“Year after year, large pharmaceutical companies rake in grossly excessive profits while hard-working Americans are forced to choose between affording their medicine and paying rent,” said Rep. Barbara Lee. “Health care is a right, not a luxury. It’s past time we enacted universal health care so our communities can get the care they need without worrying about the cost. This legislation is a critical step to expanding health care coverage on the statewide level as we work to implement Medicare for All nationally,” said Representative Barbara Lee (CA-12).
“We all could be one diagnosis away from bankruptcy. In one of the richest countries in the history of the world that is unacceptable. Health care is a human right, and this bill gets us one step closer to making sure that every single person gets the care they need—and deserve,” said Representative James P. McGovern (MA-02).
“At a time when healthcare costs are rising and millions face medical debt or lack insurance coverage, Rep. Khanna's bill is a pragmatic step toward the goal of affordable, comprehensive healthcare for all Americans. Empowering states to develop universal healthcare plans allows for local innovation while also expanding access to care. This thoughtful legislation will give states the tools they need to ensure all their residents can access the quality, affordable healthcare coverage they deserve. Medicare for All can still be achieved at the federal level, in the meantime we cannot allow millions of Americans, including nearly 300,000 Minnesotans, currently uninsured to go without coverage,” said Representative Ilhan Omar (MN-05).
"Everyone across the country should have access to quality, affordable healthcare. As we continue to work towards Medicare For All, the State-Based Universal Health Care Act will help ensure that members of our communities can access health care without being overburdened by medical debt. This bill is an important part of our work with President Biden to lower health care costs for American families,” said Representative Adam Smith (WA-09).
“The State-Based Universal Health Care Act is a crucial step towards transforming our healthcare system into one that is more equitable and accessible for all. It empowers states with the necessary resources and flexibility to tailor healthcare solutions to meet the unique needs of their residents, moving us closer to achieving universal healthcare coverage,” said Representative Shri Thanedar (MI-13).
“Americans are clamoring for reform to our broken health care system and states like California and New York are leading the way. This bill would make it easier for every state to take the necessary steps to implement single-payer health care and ensure that everyone in the state can get the care they need when they need it. Not only that, such reforms would unlock massive savings for both states and cities, many of which are facing huge increases in health care costs. We applaud Rep. Khanna for pushing forward this important piece of legislation,” said Eagan Kemp, Health Care Policy Advocate, Public Citizen.
"Rep. Khanna's reintroduction of the State-Based Universal Health Care Act (of 2023) represents a remarkable opportunity for Congress to assist states and regions in implementing universal health care systems with federal healthcare dollars and legal protections. State innovation is a hallmark of American political, economic, and social reform. This is how we expanded voting rights and ended child labor abuses. And, similar to Canada's path to national health care, through the powerful example of a single province (Saskatchewan), one, two or three U.S. states or regions will model the efficient, patient-centered, practitioner-friendly healthcare system that will go national in a few short years,” said Chuck Pennacchio, President of One Payer States.
