Medicare
The Federal State-Based Universal Health Care Waiver Act of 2015

One Agenda: Universal Health Care.
Picture courtesy of Healthcare for All Colorado
As part of the Affordable Care Act (ACA), states have been given the ability to innovate or create their own form of health care insurance or coverage starting on January 1, 2017 AS LONG AS “benefits are at least as comprehensive and affordable as those offered by Qualified Health Plans available on the Exchanges,” according to Representative Jim McDermott (D-WA-7).
As a result, at least 14 states—California, Colorado, Hawaii, Illinois, Maine, Maryland, Minnesota, Missouri, , New York, Ohio, Oregon, Pennsylvania, Vermont, and Washington—have community advocates and state legislators working towards implementing a state-level form of universal health care. They have been working for affordable healthcare access for all residents of their states before and since the Affordable Care Act – aka Obamacare – was passed in 2010.
Now that the US Supreme Court has basically settled the fact that the ACA is constitutional both on June 28, 2012 (Florida v. Department of Health and Human Services) and again on June 25, 2015 (King v. Burwell), we can consider ways to improve our healthcare system at both the state and federal level. As a medical doctor and a member of Congress, McDermott voted for the ACA. He also recognizes that “still more needs to be done to control costs, improve care, and cover everyone.”
One way to further control these costs and improve health care while covering everyone is to create a universal health care system which I’ve previously blogged about (see here, here, here, here, and here). That means we either have the federal government create a federal single payer plan OR we use the waiver clause in the ACA to help states create their own universal single-payer health care program.
Yet even with the waiver currently allowed within the ACA for innovative state-based health care plans, creating a state-based universal care plan that saves funds for states and individuals while providing health care access to all has a big hurdle to overcome. Rep. McDermott explained this issue in a speech on the floor of the House of Representatives on July 28:
One of the many achievements of the Affordable Care Act is its provisions that grant states the authority to innovate in their health care systems. Under Section 1332 of the law, a state may apply for a State Innovation Waiver that will provide it with control of federal dollars that otherwise would have been spent on premium tax credits and cost-sharing reductions for its residents. Through this waiver, a state may design a system to cover its residents, so long as benefits are at least as comprehensive and affordable as those offered by Qualified Health Plans available on the Exchanges.
However, even with this flexibility, numerous barriers limit states’ ability to design true single-payer systems. Existing waivers are narrow in scope, requiring states to seek out imperfect and convoluted solutions to circumvent federal limitations. A sweeping preemption provision in the Employee Retirement Income Security Act (ERISA) denies states authority to regulate employer-sponsored health plans. And, due to the complexities of our existing federal health programs, it is essentially impossible for a state to design a single benefit package that can be administered simply and efficiently on behalf of all of its residents.
This speech was McDermott’s announcement that he was introducing HR 3241, aka the “State-Based Universal Health Care Act of 2015:” If passed, this bill would allow states to apply for a universal health care waiver that would allow them to have access to and authority over federal health care dollars that would otherwise be spent on the residents of that state. More specifically, this additional waiver act goes beyond the ACA to deal with the hurdles mentioned above. The new provisions of this law, according to McDermott, would waive all of the following:
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The rules governing premium tax credits and cost-sharing reductions, as provided for in existing waiver authority under Section 1332 of the ACA.
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Provisions necessary for states to pool funds that otherwise would be spent on behalf of residents enrolled in Medicare, Medicaid, CHIP, TRICARE, and the Federal Employee Health Benefits Program.
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ERISA’s preemption clause, which cur-rently forbids states from enacting legislation relating to employee health benefit program
After the introduction of HR 3241, the House referred this bill to five committees — the Committee on Energy and Commerce, the Committee on Ways and Means, the Committee on Oversight and Government Reform, the Committee on Armed Services, and the Committee on Education and the Workforce. I believe that the large number of committee referrals was done because of the need to review all of the different laws that this waiver would impact.
You can read the bill in its entirety here.
I am pleased that this bill has been introduced. It however needs many co-sponsors and advocates to pressure Congress to actually hear, review, and pass this legislation. Please contact your US Representative and ask her/him to co-sponsor Representative Jim McDermott, MD’s bill HR 3241. Here’s the lookup page to find your US. Representative by zip code.
As this is the summer, your Representative should be in the home district. Call, write, set up a meeting and tell her/him why you want to see a universal health care program in your state and why this bill is so necessary. If your Representative agrees to sign on, have him/her contact Mr. McDermott’s aides that are focusing on this issue. They are Jayme Shoun, located in Seattle at (206) 553-7170 and Daniel Foster, Health Counsel in the DC Office at (202) 225-3106.
Thanks.
My Part in the #StopTheCuts TwitterStorm
Today I participated in the Coalition on Human Needs Twitterstorm to help #StoptheCuts in support of President Obama’s proposed budget that lasted from 2 to 3 pm Eastern Standard Time. Here is my contribution to that storm. Results shown are as of 3:07 pm (seven minutes after the Twitterstorm ended):
Original Tweets
Spot on! MT @kilby76 45.3 mil Americans live in #poverty. Shameful 4 richest country on earth #CutsHurt #StopTheCuts @SenToomey @SenBobCasey
0 replies 0 retweets 1 favorite
We need more investments, not less, in programs that keep even more people out of #poverty. #StoptheCuts
0 replies 1 retweet 0 favorites
FACT: Since FY2010, 136 important human needs programs were cut, 51 by > 15% #CutsHurt #FY2016 http://ow.ly/i/8uqP2 http://ow.ly/i/8uqPC
0 replies 0 retweets 0 favorites
We need a #FY2016 budget that works for all, not just corporations and the wealthy #TalkPoverty http://ow.ly/i/8upzt
0 replies 0 retweets 1 favorite
Continued cuts to human needs programs are bad for America, our economy #TalkPoverty #CutsHurt Pass @presidentobama #FY2016 budget
0 replies 0 retweets 0 favorites
Pass #FY2016 RT @BlueUpali @SenateDems #GOP thinks cuts to foodstamps SSA will help? They are bad at math as well as science. #StopTheCuts
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Only 1 in 4 households eligible for federal rental assistance receive it due to lack of funding #Sequester #CutsHurt #FY2016 #Budget
0 replies 0 retweets 1 favorite
Want to know the ins and outs of the President’s Budget? Check out @MomsRising analysis: http://moms.ly/1Ct2VX7 #StoptheCuts #FY2016
0 replies 1 retweet 0 favorites
Federal rental assistance is effective, lifts millions out of #poverty. @RepTomPrice stop the cuts, stop sequestration #cutshurt #FY2016
0 replies 0 retweets 1 favorite
Housing instability limits opportunity. Restore voucher funding so those eligible are not left waiting! #cutshurt http://ow.ly/i/8uqCu
0 replies 1 retweet 0 favorites
3 million children were lifted out of poverty by #EITC and #CTC in 2012. #CutsHurt this progress. #TalkPoverty #FY2016
0 replies 0 retweets 0 favorites
Research shows children of #EITC recipients do better in school, attend college & earn more as adults #TalkPoverty #cutshurt @RepTomPrice
0 replies 0 retweets 1 favorite
1/4 people without a high school degree are living in poverty. Tell Congress to support job training in #FY2016 #TalkPoverty #JobsNotCuts
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.@CoalitiononHN “.@BeaverValleyNOW @PA_NOW @NiTaNeeNOW Thank you for joining us and spreading the word! #StopTheCuts”
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Modified Tweets
MT @natpriorities Most Americans support spending in federal programs that help families in need. #StopTheCuts #CutsHurt http://ow.ly/i/8v627
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MT @MomsRising The earlier we invest in our littlest learners the better for our children & economy. Invest in #earlylearning! #StoptheCuts
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MT @natpriorities Only 1 in 4 households eligible for federal rental assistance receive due to low funding #Sequester #CutsHurt
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.@CongressmanGT MT @ChildDefender 57,000 children lost their Head Start cause of sequestration. #CutsHurt #StoptheCuts #BeCarefulWhatYouCut
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MT @ChildDefender 57,000 children lost their Head Start cause of sequestration. #CutsHurt #StoptheCuts #BeCarefulWhatYouCut @SenBobCasey
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MT @ChildDefender: 57,000 children lost their Head Start cause of sequestration. #CutsHurt #StoptheCuts #BeCarefulWhatYouCut @SenToomey
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MT @NAEYC: Kidsthrive & learn n society dedicated 2 ensuring they reach their full potential #investinkids n #FY2016 2 ensure their future
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MT @RESULTS_Tweets: The #2016Budget is out! Time 2 #talkpoverty w policymakers & make ending poverty a top priority: http://bit.ly/16fyKVh
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MT @MomsRising: #Congress need 2 pass tax bills that help ALL families. Write @SenateDems: http://moms.ly/1zvIHrV #StoptheCuts #CutsHurt
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MT @MomsRising: #Congress need 2 pass tax bills that help ALL families. Write @PAHouseGOP: http://moms.ly/1zvIHrV #StoptheCuts #CutsHurt
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MT @MomsRising: #Congress need 2 pass tax bills that help ALL families. Write @Senate_GOPs: http://moms.ly/1zvIHrV #StoptheCuts #CutsHurt
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MT @MomsRising #Congress need 2 pass tax bills that help ALL families. Write @HouseDemocrats: http://moms.ly/1zvIHrV #StoptheCuts #CutsHurt
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Retweets
MedicareRightsCenter @medicarerights ·
Read @josephrbaker‘s statement on the #FY2016 Obama budget: http://www.medicarerights.org/newsroom/press-releases/2315-2/ … #Medicare
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Stagnating wages & changing corporate practices decrease amt working families can save for retirement http://bit.ly/1yQBLqd #talkpoverty
0 replies 4 retweets 3 favorites
CoalitiononHumanNeed @CoalitiononHN ·
Fact: It would only take 2% of the federal #budget to reduce child #poverty by 60% http://ow.ly/InD58 #TalkPoverty @ChildDefender
0 replies 17 retweets 2 favorites
Continued cuts to human needs programs are bad for America, our economy #TalkPoverty #CutsHurt #StoptheCuts in #FY2016 #pwnspeaks
0 replies 1 retweet 0 favorites
Housing Alliance PA @PAHousing ·
Starting NOW! Tell Congress to #StopTheCuts in #FY2016! Join the @CoalitiononHN twitterstorm & tweet at your Reps/Senators #TalkPoverty
0 replies 2 retweets 1 favorite
Obama’s #FY2016 Budget requests additional funding for HUD’s Family Self-Sufficiency Program. See our FSS work: http://ow.ly/Iqp0J
0 replies 2 retweets 0 favorites
ChildrensDefenseFund @ChildDefender ·
Tell Congress: #EndChildPoverty #StoptheCuts #TalkPoverty #BeCarefulWhatYouCut http://ow.ly/H1gcu
0 replies 22 retweets 8 favorites
#StopTheCuts raise the federal minimum wage to $10.10 now and have it automatically raise thereafter. Keep people above #poverty
0 replies 3 retweets 0 favorites
CoalitiononHumanNeed @CoalitiononHN ·
1/4 people w/o a high school degree are living in poverty. Tell Congress to support job training in #StopTheCuts #TalkPoverty #JobsNotCuts
0 replies 3 retweets 0 favorites
Housing instability limits opportunity. Restore voucher funding so those eligible are not left waiting! #CutsHurt @SenToomey @SenBobCasey
0 replies 1 retweet 1 favorite
RT if OUTRAGED: 1st time in 50yrs, maj. US public school stdnts in #poverty @GOPHouse http://wapo.st/17NzFgO
0 replies 27 retweets 12 favorites
Am Sociological Assn @ASAnews ·
Is Ending #Segregation the Key to Ending #Poverty? @Stefanie_DeLuca & other sociologists http://www.theatlantic.com/business/archive/2015/02/is-ending-segregation-the-key-to-ending-poverty/385002/ …
0 replies 7 retweets 1 favorite
Parents of OMM @ParentsofOMM ·
The truth about #singlemoms using #foodstamps and what you can do to help http://bit.ly/1zkIx9w #family #poverty #welfare #womenleaders
0 replies 1 retweet 1 favorite
Join the #StopTheCuts TwitterStorm
Yesterday, I received a phone call from Paul Wommack, a Beaver Valley NOW member and activist. He alerted me to an online effort to influence Congress to support President Obama’s proposed budget.
This budget was officially released this morning. Part of the proposed budget would add new investments in child care programs and increase access to community colleges across the country. It also will, if passed, start to reverse the damage that has been made to social service programs due to, among other things, the sequestration mandate of the past several years.
As a result of this positive change that could come at the Federal level IF Congress listens and passes a budget to “Stop the Cuts” to our social network fabric, the Coalition on Human Needs has organized a “#StopTheCuts” Twitter Storm for Tuesday February 3, 2015 at 2 pm EST/11 am PST. Here’s their announcement with details in case you too would like to participate.
Twitterstorm 2/3: Tell Congress to #StopTheCuts
This coming Monday the President will present his budget request to Congress for FY2016. We look forward to reviewing the President’s proposals, and we’ve already heard about important investments he’d make in child care and community college. We’ve heard he will start to reverse damaging cuts to human needs programs. Our next step: we need you to join us in telling Congress our request – stop the cuts.
On Tuesday, February 3rd at 2pm ET/11am PT, join the Coalition on Human Needs, MomsRising.org, MoveOn.org, and other national organizations [including the National Organization for Women] for a Twitterstorm (sample tweets and graphics below!). Tell Congress that their FY2016 budget must protect programs that promote shared prosperity and help our nation’s most vulnerable.
Strong, well-funded federal programs create jobs, grow the economy, reduce inequality, and keep millions out of poverty. In 2013, 3.7 million people were kept out of poverty by SNAP benefits. Similarly, unemployment insurance kept 1.2 million people out of poverty. The Earned Income Tax Credit (EITC) and Child Tax Credit lifted 10.1 million people, including 5.3 million children, out of poverty in 2012. And the list goes on…
But if the new Congress drafts a budget anything like the one the House passed last year, these successful programs will be slashed, along with education, housing, nutrition, and other services young and old alike need to escape poverty. These will be on top of years of cuts that are keeping us down. It’s time to tell Congress to #StopTheCuts.
Tell Congress real people are being harmed. On February 3rd raise your voice for human needs and share the real struggles people in your community face and the impact of cuts. Below are sample tweets – but we encourage you to tweet at your Senators and Reps with personal stories, too.
Who? You and/or your organization
What? A twitterstorm telling Congress to stop cuts to the programs that are most important to our nation’s future shared prosperity and ending poverty in America.
Where/When? Twitter, February 3, at 2pm ET / 11am PTHow? Post the tweets and graphics below telling Congress to #StopTheCuts because #CutsHurt. Have you or someone you know benefited from the programs facing cuts? Get personal!
Please spread the word and email your networks and this event. Here is the link to our blog post with this info. If your organization plans to participate, please RSVP to Joanna at jsandager@chn.org so that we can list you as a participant.
And make sure to follow us on Facebook and Twitter at @CoalitiononHN for the latest.Sample Promotional Tweets:
- Join @CoalitiononHN @MomsRising @MoveOn 4 a twitterstorm on 2/3 @ 2PM ET! Tell Congress to protect essential programs b/c #CutsHurt
- Tell Congress to #StopTheCuts in #FY2016! Join the twitterstorm + tweet at your Reps/Senators 2/3 @ 2PM ET #TalkPoverty #EndPovertyNow
- 3 mil Americans live in #poverty. On Feb 3, 2pmET Tell Congress cuts to human needs programs are bad for America, our economy #CutsHurt
Sample Tweets
- We need more investments, not less, in programs that keep even more people out of #poverty
- We need a #FY2016 budget that works for all, not just corporations and the wealthy #TalkPoverty
- Continued cuts to human needs programs are bad for America, our economy #TalkPoverty #CutsHurt
- In 2013, 3.7 million were lifted out of poverty by #SNAP. #CutsHurt this progress. #TalkPoverty
- Only 1 in 4 households eligible for federal rental assistance receive it due to lack of funding #Sequester #CutsHurt #FY2016 #Budget
- Federal rental assistance is effective, lifts millions out of #poverty. @RepTomPrice stop the cuts, stop sequestration #cutshurt #FY2016
- Housing instability limits opportunity. Restore voucher funding so those eligible are not left waiting! #cutshurt
- 3 million children were lifted out of poverty by #EITC and #CTC in 2012. #CutsHurt this progress. #TalkPoverty #FY2016
- Research shows children of #EITC recipients do better in school, attend college & earn more as adults #TalkPoverty #cutshurt @RepTomPrice
- 1/4 people without a high school degree are living in poverty. Tell Congress to support job training in #FY2016 #TalkPoverty #JobsNotCuts
- FACT: Since FY2010, 136 important human needs programs have been cut, 51 by more than 15% #CutsHurt #FY2016
Sample Graphic