Note: Congresswoman Jayapal introduced a bill that would allow states to have their federal Medicare dollars for a state health care plan. It also has provisions to provide waivers for other federal health insurances and laws. Her intention is to facilitate states that are seeking to create a health care plan that is closer to being universal.

Jayapal’s bill, if it becomes law, will open the door to dismantling Medicare state-by-state, a dream of free market conservatives. While her intentions are good – trying to put in systems that are closer to being universal – those systems will either be watered down to the point of being ineffective or will be ignored. Even under President Obama, when states and corporations complained about the requirements of the Affordable Care Act and applied to the Department of Health and Human Services to be excused from them, they were granted those exceptions.

In the past, whenever a member of Congress introduced a similar plan, the single payer movement strongly opposed it. Now there is silence.

We cannot allow Medicare to be dismantled at the state level. Allowing individual states to decide has always meant that states, particularly southern states, create discriminatory systems that hurt poor and black communities.

We are fighting for a National Improved Medicare for All so that every person in the United States and its territories will have the same high quality, comprehensive health care. We are not working to destroy one of our best systems, Medicare.

– Margaret Flowers


By Rich Smith for The Stranger

Surrounded by state and local politicians in Post Alley on a sunny Monday afternoon, Congresswoman Jayapal officially introduced The State-Based Universal Health Care Act. In essence, the bill would allow states or even entire regions to redirect federal health care funds to pay for “state-based universal health care systems.” Passing the bill is a necessary step for politicians and organizations pursuing legislative efforts to bring a single-payer health care system to Washington State, where health insurance premiums are due to jump by 19 percent next year.

During the press conference Rep. Jayapal admitted the House likely won’t pass the bill this year, but she predicts its chances might drastically improve if Democrats take back Congress in 2018. “Do I believe it could happen next year or the year after that—and I’m shooting for next year—yes,” she said.

When asked, Jayapal didn’t specifically mention any U.S. Senators proposing companion bills, but said there is “a lot of movement” on the issue in the Senate.

Rep. Jayapal’s bill would require any state or regional program to offer the same amount of benefits to the same number of people as the current cocktail of federal programs do now. According to a draft of the bill, an “independent panel of health care experts and officials” would be set up to ensure that the state was providing “as much as or more coverage than the individual streams.” Plus, there’s no bar on “supplemental coverage,” so people could still buy private insurance plans if they wanted to.

“To do it the right way you’ve got to get this kind of flexibility going,” said Washington State Sen. David Frockt, whose state-level single-payer bill died in a Senate committee earlier this year thanks to the coward Sen. Mark Mullet of Issaquah. “We don’t have any flexibility right now…But if you have a bill like [Jayapal’s] get through, that gives us a window to build a case over the next several years.”

Fans of former Seattle Rep. Jim McDermott might remember his version of The State-Based Universal Health Care Act from a few years ago. That bill died in committee in 2015. But Jayapal’s version differs in some pretty significant ways. It replaces an existing waiver that Republican Governors have been using to push work requirements for Medicaid with a new one that can only be used for universal health care programs.

The bill also adds more oversight than McDermott’s version. In order to continue receiving the waivers, five years after implementing the new system, states would have to show that they’re covering at least 95 percent of the population, plus show how they plan to cover the remaining five percent.

“This is not some crazy liberal idea, it’s actually what voters across the country want,” Jayapal said, referencing a recent poll that found majority support for “Medicare for All” among voters in 30 swing districts.

But the bill will likely die again—even if Democrats win the House in 2018—unless it gets substantial support from Democrats in Congress. I’ve e-mailed every member of Washington’s Congressional Delegation, and I’ll update this post if I hear back from any of them.

In the meantime, you can always call them yourselves and demand they support this legislation.

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