Why the State-Based Universal Health Care Act appeals to supporters of (Improved) Medicare for All
The State-Based Universal Health Care Act (HR 6270) allows states to experiment effectively in creating universal healthcare programs.* American healthcare is too expensive, excludes too many, and is too complex. Since Congress has been unable to fix it, permitting states to try various new approaches with federal dollars could really help.
The Centers for Medicare and Medicaid Services (CMS) can grant waivers bypassing specific CMS rules that hinder states from financing, organizing, and delivering health care in ways best suited for each state. More than 50% of healthcare funds in a state flow through federal programs, primarily Medicare, Medicaid, and the Childrens' Health Insurance Program (CHIP). These programs reimburse providers at a much lower rate than private insurance, creating inequities and difficulties in finding willing providers. HR 6270 would help solve this problem, but the Affordable Care Act does not yet allow states to use federal money for state-based universal healthcare systems. The HR 6270 Act would clarify this matter with specific waiver authority to help state programs survive legal challenges related to Medicare and ERISA (Employee Retirement Income Security Act of 1974) rules.
Advocates in at least nineteen states are actively pursuing state-based universal healthcare plans. Most have done economic feasibility studies. These advocates have in common the desire to expand benefits to every resident, make quality health care truly affordable, and end the massive amounts of administrative waste and price gouging. The HR 6270 Act would greatly help states reach these goals. Two or more states could collaborate under a waiver.
There is no question that a national improved Medicare for All remains the goal. How to get there is the question. One or more states can become models for other states, and eventually the nation, to follow, as happened with Canada’s provinces.** Throughout U.S. history, states have been laboratories for social justice, including slavery abolition, women’s suffrage, Social Security, direct election of Senators, child labor laws, prohibition of indoor smoking, same-sex marriage, and even the Affordable Care Act. HR 6270 allows states to receive federal healthcare dollars while exploring more equitable approaches to financing healthcare.
Can we trust states to use the Act appropriately? The Act has a number of guardrails to prevent abuse. For example, coverage must be as comprehensive and affordable as the federal programs for which residents would otherwise be eligible.
"Medical costs are the tapeworm of American economic competitiveness." - Warren Buffett***
More information? Chuck Pennacchio, cpennacchio@gmail.com, (215) 828-5055, onepayerstates.org
Text of HR 6270: https://www.congress.gov/bill/118th-congress/house-bill/6270/text
** https://www.commondreams.org/opinion/state-based-single-payer-healthcare
*** https://www.wsj.com/articles/warren-buffett-sure-does-like-to-say-tapeworm-1517325314