Bill · S. 2286· Senate(119-S-2286)
State-Based Universal Health Care Act of 2025
- Introduced
- 7/15/2025
- Last activity
- 7/15/2025 — Read twice and referred to the Committee on Finance.
- Sponsored by
- Edward Markey
- Cosponsors
- - 3 - 0
- Introduced
- In Committee
What this bill would do
The State-Based Universal Health Care Act of 2025 aims to amend the Patient Protection and Affordable Care Act to allow States to establish universal health care systems. It creates a framework where States can apply for a waiver to implement comprehensive coverage for their residents. These plans must meet specific coverage, affordability, and administrative requirements. The bill establishes an Independent Assessment Panel to review State applications and reports. It also provides guidelines to ensure specific protections for American Indians and Alaska Natives.
Yes· 3 of 11
Would Native Americans be better off under this?+9
The bill includes specific protections to ensure no cost burdens are placed on American Indians receiving services.
Does this make health care easier to get in general?+9
The bill enables states to implement comprehensive universal health care coverage for residents.
Would households on low incomes be better off under this?+8
The bill aims to provide comprehensive health coverage to all residents, which strongly benefits low-income families.
The opposite
No question was scored the opposite.
Who it would affect, and how
Potential Positive Impacts for People
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Comprehensive Health Coverage: States can implement plans that provide coverage to all residents, including those currently covered by various Federal health or subsidy programs (Section 2(b)(1)(D)).
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Affordability Protections: The bill requires State plans to provide coverage and cost-sharing protections against excessive out-of-pocket spending that are at least as affordable as existing Federal programs (Section 2(b)(1)(C)).
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Reproductive Health Care: Approved State plans must provide coverage for reproductive health care services, including abortion, contraception, and gender-affirming care (Section 2(b)(1)(I)).
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Protection for Indian Residents: The bill includes guidance to ensure no enrollment fees, premiums, or similar charges are imposed on Indians receiving services through a waiver, with costs borne by the Federal Government (Section 2(h)(1)(B)).
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Public Information: States are required to conduct public education activities to raise awareness about coverage availability and facilitate enrollment (Section 2(b)(1)(E)).
Potential Negative Impacts for People
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Exclusion of Certain Groups: The requirement to provide coverage to all residents excludes individuals who are eligible for benefits through the Indian Health Service or for benefits and services under title 38, United States Code (Section 2(b)(1)(D)).
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Potential for Program Termination: If a State fails to achieve health coverage for at least 95 percent of its residents, its waiver may be terminated at the discretion of the Secretary (Section 2(e)(2)(A)(iii)).
Groups and Interests Ranking
Every group the model scored this bill for, from -10 to +10. Hover a score for the reason it gave.
- Demographic And Interest Groups
- Good For Native Americans+9Good For Low Income Households+8Good For L G B T Q Community+7Good For Middle Class Households+7Good For Women+7Good For Immigrants+6
- Healthcare
- Improves Healthcare Access+9Improves Abortion Access+8Increases Affordable Care Act Support+7
- Social Issues And Justice
- Improves L G B T Q Rights+7
- Governance And Ideology
- Increase States Rights+6
- 7/15/2025
- Read twice and referred to the Committee on Finance.
- 3 Cosponsors added.
- Introduced in Senate
One bill Congress.gov lists as related to this one — companions in the other chamber, earlier versions, and bills this one absorbed or was folded into.
Jeff MerkleyDemocrat · Oregon
Alex PadillaDemocrat · California
Elizabeth WarrenDemocrat · Massachusetts