Originally Published in the December 2019 issue of The Retiree Advocate, a newsletter of the Puget Sound Advocates for Retirement Action Education Fund.
Click here for a summary of HR 5010 and a FAQ Sheet.

On November 8, Bay Area Rep. Ro Khanna (CA-17) introduced the State Based Universal Health Care Act of 2019 (SBUHC or HR 5010) with 15 original co-sponsors, including our own Pramila Jayapal and Adam Smith. This represents an important step in building the movement for a universal national health plan and Medicare for All.
The SBUHC proposal was first introduced by Congressman Jim McDermott
in 2015, and then by Congresswoman Pramila Jayapal in 2018 – both leading advocates of a universal, publicly funded national health plan. Indeed, Jayapal is now prime sponsor of HR 1384, Medicare for All, and Co-Founder of the Medicare for All Congressional Caucus.
The idea behind SBUHC as a pathway to a national plan starts with the reality that several states (including California and New York) are getting close politically to creating universal health care systems, thanks to years of grass-roots campaigns. But to succeed, states would need control of the federal health care dollars flowing to their states (Medicare, Medicaid, CHIP, TRICARE and Affordable Care Act) as well as the regulatory authority to require participation from large, self-insured employers.
The second basis of the SBUHC initiative is the recognition that while
public and Congressional support for universal health care and Medicare for All are at an all-time high and growing, the health care industry and its Republican and Democratic allies will mount an increasingly aggressive campaign to defeat the idea in Congress. Even with Democrats in control of the White House and both houses of Congress in 2021, it may take more than one election cycle to overcome the opposition to a universal, public national health plan. Passage of SBUHC might well be an easier political lift in DC. But starting at the state level has its own advantages.
“I’m proud to support this critical bill, which builds on my state-based universal health care legislation from last Congress. So many progressive accomplishments have started at the state level and grown to fuel national change. Americans are fed up with a broken health care system that lines the pockets of insurance and drug company executives at the expense of families struggling to keep up with skyrocketing costs. Supporting state-based universal health care efforts will help build momentum for the grassroots energy we need to achieve bold, structural federal reforms through Medicare for All.”
– Rep. PRAMILA JAYAPAl,
from Rep. ro Khanna’s Press Releasing announcing the Bill
Indeed, many of our important national policies first started at the state
level. Think marriage equality, abortion rights, Social Security and much more.
This year the WA State Legislature created a Universal Health Care Work
Group to study how our state could achieve universal and affordable health
care. The Work Group includes representatives of consumers, labor, business, health care providers, community health advocates and legislators. It is to report its recommendations to the Legislature right after the 2020 elections. Now it will have SBUHC to consider as
one pathway to the goal.
Advocates for SBUHC in the health justice movement and in Congress are clear that SBUHC and Medicare for All are parts of a two-track, state-federal strategy. It is time for us to win more co-sponsors from our WA Congressional Delegation for both SBUHC and Medicare for All (HR 1384 and S. 1129), and to persuade our state legislators to support a universal and affordable plan for all Washingtonians. If we make this a winning issue in the 2020 elections, we can make real progress in 2021.