State Based Universal Healthcare
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State Based Universal Healthcare
In this newsletter we have advocated, long and loud, for Universal Healthcare. Our 35 peer industrialized nations all have it. They save a fortune, deliver quality care to everyone and bankrupt no one. They have developed unique ways to implement and pay for their systems.
We have advocated for a single payer system, like Rep. Jayapal’s HR 3421. It is a single payer system in which the government operates the insurance company. A way to think of it is, “Public Insurance Paying Private Providers.” That model works really well with traditional Medicare (not Medicare Advantage).
Congress is at loggerheads with itself now. There is an important struggle to keep democracy in place in our country as opposed to an authoritarian dictatorship. We can argue about that all day, and that’s the problem. We argue about that all day and there is no time left to fix healthcare.
One Payer State Based Insurance
Some states are considering taking action instead of waiting for the federal government. They would like to establish a state wide single payer universal healthcare system for all their residents. The states working on it so far are: California, Colorado, Illinois, Maine, Maryland, Minnesota, Missouri, New Jersey, New York, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Vermont and Washington. Here is a link to a Healthcare Now webpage that describes each state’s activity.
Here is how it would work:
State-based one-payer plans (SB-OP) require a state to collect federal, state, and private healthcare spending into a single pool. A designated state agency then pays all providers for all patients. Hence the term “One Payer”: Providers receive payment from a single payer.
It’s a good idea since it will demonstrate how to implement the system and stands a pretty good change of passing at the state level before the federal.
There is coordination with federal agencies that must be accomplished to make it happen and that’s the subject of today’s article.
If a state wants to implement such a system they must enroll Medicare, Medicaid, federal employees, and Tricare (military families and retirees) subscribers. The states will need waivers from the federal government to do that. The states must also be able to have private employers offer the state based insurance to employees. To do that there needs to be a waiver from the Employee Retirement Income Security Act (ERISA). There also needs to be some coordination with the IRS since employers payments for health insurance premiums are pre tax dollars, and individuals who purchase insurance on their own use after tax dollars.
So there are quite a few waivers. Well, Representative Ro Khanna of California has grouped them all together in a single bill that he will be introducing to Congress shortly and we can help this effort by encouraging our representatives and senators to co sponsor and support it.
The single bill would provide all required waivers and exemptions and are contained in one act of Congress, directed to each appropriate federal office for prompt action. The required waivers do not sunset. They are valid as long as the state demonstrates continued compliance with essential requirements:
Coverage of at least 95% of the state population.
All patients previously covered by a federal program continue to enjoy benefits at least as comprehensive as the original program.
Federal debt does not increase.
The bill is called State Based Universal Health Care. Thanks to One Payer States for the heads up.
ACTION
Rep. Khanna's State Based Universal Health Care bill (SBUHC) will modify the federal restrictions on Medicare, Medicaid, ERISA, and taxation, allowing states to create universal healthcare systems.
First, let’s call our Representative and Senators (202-224-3121) today and urge them to cosponsor and support SBUHCA. Click HERE to view SBUHCA talking points. (tailored for Oregon, but the message is clear).
Next we can send an email to them using these links from One Click politics. You can also forward these links below in email/texts/social media. Note there is a One Payer contact button below your name and address. Leave it checked if you want One Payer States to get in touch with you. There is no request for donations.
Send an SBUHC message for Representatives. Send an SBUHC message for Senators.
RESOURCES
Healthcare Advocacy (Us)
Website
Our Newsletter resources including reproductive healthcare
Healthcare Advocacy Reading List
Find My Elected Officials
Contact the White House https://www.whitehouse.gov/contact/
Contact State and Federal Representatives
By phone: (202) 224-3121
By email: democracy.io
Important Healthcare Resources
League of Women Voters Healthcare Reform Toolkit
Organizations to Contact
National Nurses United Medicare4All
Physicians for a National Health Program
One Payer States
Healthcare Now
Reproductive Health
NARAL - Pro Choice America
Charley. chatbot abortion resource - make sure to use a secure incognito browser if you live in a state that has banned abortion
Planned Parenthood
Miscarriage and Abortion Hotline has references about where to procure abortion medications. They also assist women in the process of self managed abortion or miscarriage by phone or text and will respond in an hour. Details and hours of operation at their website.
United State of Women Reproductive health page (bottom of the page) has important resources such as medical support, access to Telehealth, prescriptions by mail, and legal support references.
Practice careful communications - The Digital Defense Fund has a number of tips to keep texts, calls, and internet use private. Here is their site.
If you need financial help with an abortion try abortionfunds.org
Claims Denials and Appeals & What to Do
Appeal a Healthcare Decision
Appeal/Negotiate a Hospital Bill
Disinformation Management
Cybersecurity Infrastructure Security Agency
Save Democracy
Chop Wood, Carry Water by Jessica Cravens
RESISTBOT
Link to the RESISTBOT site to learn more
Link to Chop Wood, Carry Water RESISTBOT write up
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Alan, thank you for addressing the button-link issue. (Note: it wasn't the first time this had happened.) I think it's ironic, Adam Schiff was sitting at the Burbank Mall when someone made the genocidal eugenics comment to him. Burbank? Luther Burbank? One of history's great plant breeders, he also advocated for human eugenics. The name was coincidental, however. The mall (and city) were named for a different person.
Just gave today's post a quick first read. Federal vs state-based single payer? I'm an agnostic and support both approaches. I'm glad Ro Khanna is stepping up with a commonsense basket of waivers. A few concerns, none of which are showstoppers compared with the good that could result...
> I live in Texas, population about 30 million. Covering "at least 95%" under Khanna's bill would invite corrupt-to-the-core Texas politicians to exclude perhaps 1,500,000 Texas residents. (Note: by stonewalling Medicaid expansion, these far-right racist mofos currently exclude some 5,000,000 Texas men, women and children despite generous federal incentives. If there's a way to screw up or circumvent a pro-social federal program, Texas will do it from sheer meanness and spite.)
> Across America's mass-incarceration gulag, many prisons and jails offer egregiously poor healthcare for inmates. Will any provision in Khanna's bill, force that to change in states that opt for waivers?
Add'l thoughts:
> Kudos to One Payer States as a longtime grassroots leader banging the drum for state-based universal care.
> How to sell this concept to conservative politicians, pundits and voters? Advocates might frame it up as a "states' rights" issue.
Thanks for spotlighting this alt approach to giving single-payer universal healthcare a toehold at least somewhere in the US.
p.s. I clicked a Comment button on today's (10.18.23) email, and it posted my comment to some weeks-old post. I'm now redoing my comment here, on the correct page. Could you please fix this problem of buttons misdirecting comments? Thank you!