Why the State-Based Universal Health Care Act appeals to people who are not yet quite on board for (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.
More than 50% of a state's healthcare funds flow through federal programs, primarily Medicare, Medicaid, and Children's Health Insurance Program (CHIP). A state may want to implement a system that includes individuals who qualify for one of these programs, but it would need federal funds to pay for the appropriate services. HR 6270 provides a mechanism that ensures the state will continue to receive these funds.
Federal law allows the Health and Human Services (HHS) Secretary to grant waivers for appropriate Medicaid and ACA rules. Medicare waiver authority is much less clear. A waiver of the Employee Retirement Income Security Act of 1974 (ERISA) authority does not exist. The Act would provide explicit waiver authority for these federal rules, giving states more flexibility and freedom.
HR 6270 establishes a review panel to recommend approving a waiver request. This review panel includes a bipartisan group – a member recommended by the Speaker of the House of Representatives, the minority leader of the House, the majority leader of the Senate, the minority leader of the Senate, the Republican Governors Association, the Democratic Governors Association, and a member from the patient advocacy community, a labor organization representing nurses, another labor organization representing health care workers, a representative of primary care physicians, and a representative of health care professionals practicing in rural or underserved areas. 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.wsj.com/articles/warren-buffett-sure-does-like-to-say-tapeworm-1517325314