"State-Based Universal Health Care Act” (H.R. 6270)

The “State-Based Universal Health Care Act” (SBUHCA) makes it easier for states to create and fund a comprehensive universal health care plan by allowing a waiver of some federal rules. To waive requirements for a federal program, the state plan must have benefits equal to or greater than those that the beneficiaries of the federal healthcare program would otherwise receive. A group of states can also submit a joint plan. This bill was introduced in late 2023 by U.S. Representative Ro Khanna (CA-17) as H.R. 6270. 

Section 1332 of the Affordable Care Act (ACA) allows states to innovate, but it does not go far enough.  SBUHCA amends the ACA with a 1335 super-waiver, which provides additional federal support for states to develop their own universal healthcare plans. Section 1335 makes it easier for states to model systems and build toward a national healthcare plan. 

What SBUHCA does:

• Allows states to get federal waivers for a universal, simple, and affordable (USA) plan.

• Mandates that participating states guarantee healthcare coverage for at least 95% of residents in the first 5 years.

• Requires any state-based plan to have benefits equal to or greater than those that the beneficiaries of federal healthcare programs now receive.

• Allows groups of states to come together for joint plans. Section 1332 of the Affordable Care Act (ACA) does not.

• Enables states to integrate Medicare funds into a state plan. Section 1332 does not. 

• Gives access to an ERISA waiver to reduce legal challenges to a state plan. Section 1332 does not. This gives states more legal certainty in legislative efforts.

• Creates an HHS Secretary-appointed Independent Assessment Panel, composed of members recommended by political leaders of both parties, health care provider groups, and a patient advocate [see Section 2 (g) (4) of H.R. 6270]. This panel will review and provide the state and the Secretary recommendations regarding waiver approval or disapproval. By contrast, Section 1332 leaves the review process up to the HHS Secretary.

• Paves the way to nationally guaranteed universal, simple, affordable (USA), and equitable health care.