POSITIVE Healthcare 118th Congress

H.R.6270 State-Based Universal Health Care Act of 2023

Allows states to create their own single-payer universal healthcare systems using federal waivers (118th Congress)

Legal & Constitutional Grounding

U.S. admin costs are 34% of health spending vs. 17% in single-payer systems (Annals 2020).

Himmelstein et al., Annals of Internal Medicine (2020) — U.S. admin costs 34.2% vs. 17% in Canada

ACA § 1332, 42 U.S.C. § 18052 — State Innovation Waiver
Galvani et al., Lancet (2020) — single-payer saves 68,000 lives annually

Allows states to create single-payer universal healthcare via federal waivers. State-level innovation provides a pathway to universal coverage, enabling states to test systems that reduce administrative costs and eliminate coverage gaps.