Los Angeles Times
May 25, 2012
Legislation may enable states to offer universal healthcare
By David Lazarus
Universal coverage, Medicare for all, single payer — call it what you will. It's clear that conservative forces are determined to prevent such a system from ever being introduced at the national level. So it's up to the states.
The catch is that to make universal coverage work at the state level, you'd need some way to channel Medicare, Medicaid and other federal healthcare funds into the system. At the moment, that's difficult if not impossible.
But legislation quietly being drafted by Rep. Jim McDermott (D-Wash.) would change that. It would create a mechanism for states to request federal funds after establishing their own health insurance programs.
If passed into law — admittedly a long shot with Republicans controlling the House of Representatives — McDermott's State-Based Universal Healthcare Act would represent a game changer for medical coverage in the United States.
It would, for the first time, create a system under which a Medicare-for-all program could be rolled out on a state-by-state basis. In California's case, it would make coverage available to the roughly 7 million people now lacking health insurance.
"This is a huge deal," said Jamie Court, president of Consumer Watchdog, a Santa Monica advocacy group. "This is a lifeline for people who want to create a Medicare system at the state level."
I learned of McDermott's bill after getting my hands on documents he had sent to other members of Congress seeking support for the legislation.
McDermott's office confirmed that the documents and legislation are real but declined to make the congressman available for comment until the bill is formally introduced, which could happen as soon as next week.
Comment: Rep. Jim McDermott's State-Based Universal Healthcare Act can indeed be a real game changer. Currently it is impossible for states to establish a bona fide single payer system because they would need to have full control of the funds delegated for current federally funded health care programs such as Medicare, Medicaid and CHIP, and they would need relief from federal regulations such as those in ERISA. As it is being developed, this legislation would grant states the freedom to establish their own relatively autonomous system as long as it met certain very basic federal standards (i.e., that it actually would achieve the goal of adequate health care coverage for essentially everyone).
Many conservatives such as Mitt Romney who are opposed to the Affordable Care Act ("Obamacare") have said that the states should be allowed to make their own decisions on health care reform. In fact, Gov. Romney supported and signed into law the Massachusetts reform plan ("Romneycare" which is a model very similar to that of the Affordable Care Act). He has stated repeatedly that, if elected President, he would support the repeal of "Obamacare," but that in its place he would support states in their efforts to enact their own reform. Rep. McDermott's legislation would provide the states with that opportunity. This legislation would allow conservatives in Congress to stand up for states' rights, while joining with progressives who would like to see better and more effective use of our health care funds.
When the bill is released in the next week or so, we will then have the details. In the meantime, we can be reassured that reform does not stop with the partial and inadequate measures of the Affordable Care Act, regardless of the pending decision of the Supreme Court on the constitutionality of the Affordable Care Act.
(At this point, I would like to publicly extend my apologies to Rep. McDermott and his staff since I was the source of the documents that were provided to David Lazarus. These documents were circulating within the single payer and the legislative communities, and, quite naively, I did not realize that they were under embargo, though I should have. I just didn't think about it. David Lazarus is a highly credible and exceptionally ethical reporter of health care and other consumer issues, and I thought that it would be great for him to cover this important legislation. Premature release of the preliminary documents was my error, and mine alone.)