H.R.5010: State-Based Universal Health Care Act of 2019


The State-Based Universal Health Care Act would give states regulatory flexibility and access to federal funding in order for them to implement universal healthcare programs.
Specifically, the bill would repeal and replaces existing Section 1332 waiver provisions under the Affordable Care Act (also known as State Innovation Waivers) with waiver provisions that allow states to establish comprehensive universal health care plans, in accordance with specified requirements. Under current law, States that want to create a public health insurance alternatives are restricted in their use of federal dollars that are direct to programs such as CHIP, Medicaid, and ACA subsidies. This dilemma has lead to a number of states not expanding healthcare coverage because of fear that previously allocated federal funding would withhold from that state.

This bill would create a waiver that a state or group of states could apply for that would consolidate the federal funding to that state as a lump sum annual payment for that state or region to create their universal health care system. To apply for the waiver, participating states or groups of states would have to propose plans to provide health care coverage for 95 percent of their residents (along with specified quality coverage requirements) within five years. States that do not reach the 95 percent target after five years would have to revise their plan to achieve the objectives or risk losing their waiver. The bill would also make federal technical assistance available for states seeking help in developing and implementing these plans.

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Our Stance




Bill Number


Date Introduced

November 08, 2019


House Education and Labor Committee

Bill Status

Introduced or Prefiled


Rep. Ro Khanna