Introduction to the State-Based Universal Health Care Act (SBUHCA)   

What is the SBUHCA? The State-Based Universal Health Care Act (HR 6270) is a bill that provides a one-step waiver application process for states to access federal healthcare funds that are needed to make state-based universal healthcare a reality. Waivers allow states to bypass various federal requirements that would otherwise prevent them from creating an innovative new program. Even though waivers are already available for many federal healthcare programs, no procedure currently exists to divert healthcare dollars to a state fund, nor does any exist to help states include self-insured employer plans in their unified system.

Why is it needed? While it might be possible to establish a state-based universal program without the SBUCHA, passage would make the process far less complex and minimize legal challenges by eliminating much of the uncertainty regarding the state’s authority. No one should struggle to access health care. Ready states should be able to create their own Universal, Simple, Affordable (USA) health plans for their residents.

But why not move directly to a national universal system? There is no question that a national universal program (as Medicare was originally envisioned in 1964) is the best option. Unfortunately, the movement toward this goal has been stalled for decades. However, throughout American history, states have served as laboratories to develop social innovations for the entire nation, including the abolition of slavery, 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. So it’s likely that if one or more states were to model a successful program, a national, Improved Medicare for All plan would follow.

How many states need the SBUCHA? At least 19 states actively pursue state-based universal healthcare, involving thousands of dedicated volunteers. Many states have done their own economic feasibility studies that project a Universal, Simple, and Affordable system that will save billions of dollars. These states have a common goal of providing comprehensive benefits for every resident and making quality health care truly affordable.

Could a state use the SBUCHA for unintended purposes? Not if it follows the law. The bill 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.  

Where can I get more information? Visit the One Payer States website, and here, and here.