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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)

View on Congress.gov

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

Bill activity

Introduced Nov 7, 2023 by Ro Khanna (D-CA) with 26 original cosponsors. 30 cosponsors as of Oct 8, 2024.

Rep. Pat Ryan (D-NY-18) is not listed among the cosponsors of this bill.
  1. IntroducedNov 7, 2023
  2. Passed House 
  3. Passed Senate 
  4. To President 
  5. Became Law 

Latest action Dec 17, 2024: Referred to the Subcommittee on Health.

Cosponsors during the cosponsorship window

118th Congress (Jan 2023 to Jan 2025)

Jan 2024FebMarAprMayJunJulAugSepOctNovDecNov 7, 2023Jan 3, 2025 (closed)26 originalAdam B. Schiff (D-CA-28). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Adam Smith (D-WA-9). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Andrea Salinas (D-OR-6). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Ayanna Pressley (D-MA-7). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Barbara Lee (D-CA-12). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Becca Balint (D-VT). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Bonnie Watson Coleman (D-NJ-12). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Cori Bush (D-MO-1). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Dean Phillips (D-MN-3). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Delia C. Ramirez (D-IL-3). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Earl Blumenauer (D-OR-3). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Eleanor Holmes Norton (D-DC). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Ilhan Omar (D-MN-5). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Jamaal Bowman (D-NY-16). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.James P. McGovern (D-MA-2). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Janice D. Schakowsky (D-IL-9). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Jared Huffman (D-CA-2). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Jesus G. "Chuy" Garcia (D-IL-4). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Joe Neguse (D-CO-2). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Mark Pocan (D-WI-2). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Pramila Jayapal (D-WA-7). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Rashida Tlaib (D-MI-12). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Raúl M. Grijalva (D-AZ-7). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Shri Thanedar (D-MI-13). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Suzanne Bonamici (D-OR-1). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Val T. Hoyle (D-OR-4). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Chellie Pingree (D-ME-1). Cosponsored Nov 21, 2023, 14 days after introduction.Summer L. Lee (D-PA-12). Cosponsored Dec 7, 2023, 30 days after introduction.Steve Cohen (D-TN-9). Cosponsored Dec 12, 2023, 35 days after introduction.Sheila Cherfilus-McCormick (D-FL-20). Cosponsored Oct 8, 2024, 336 days after introduction. Mar 2024MayJulSepNovNov 7, 2023Jan 3, 2025 (closed)26 originalAdam B. Schiff (D-CA-28). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Adam Smith (D-WA-9). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Andrea Salinas (D-OR-6). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Ayanna Pressley (D-MA-7). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Barbara Lee (D-CA-12). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Becca Balint (D-VT). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Bonnie Watson Coleman (D-NJ-12). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Cori Bush (D-MO-1). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Dean Phillips (D-MN-3). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Delia C. Ramirez (D-IL-3). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Earl Blumenauer (D-OR-3). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Eleanor Holmes Norton (D-DC). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Ilhan Omar (D-MN-5). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Jamaal Bowman (D-NY-16). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.James P. McGovern (D-MA-2). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Janice D. Schakowsky (D-IL-9). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Jared Huffman (D-CA-2). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Jesus G. "Chuy" Garcia (D-IL-4). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Joe Neguse (D-CO-2). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Mark Pocan (D-WI-2). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Pramila Jayapal (D-WA-7). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Rashida Tlaib (D-MI-12). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Raúl M. Grijalva (D-AZ-7). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Shri Thanedar (D-MI-13). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Suzanne Bonamici (D-OR-1). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Val T. Hoyle (D-OR-4). Cosponsored Nov 7, 2023, on the day of introduction. Original cosponsor.Chellie Pingree (D-ME-1). Cosponsored Nov 21, 2023, 14 days after introduction.Summer L. Lee (D-PA-12). Cosponsored Dec 7, 2023, 30 days after introduction.Steve Cohen (D-TN-9). Cosponsored Dec 12, 2023, 35 days after introduction.Sheila Cherfilus-McCormick (D-FL-20). Cosponsored Oct 8, 2024, 336 days after introduction.
Democratic 30

Each dot is one cosponsor. Dots stack by sign-on day, or by week when the window is long. The block at the left holds the original cosponsors.

Cosponsorship closed Jan 3, 2025 (118th Congress): the Congress ended with the bill still in committee.

Activity log

Source: Congress.gov actions
  1. Introduced in House
  2. Referred to the House Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, Armed Services, Oversight and Accountability, and Education and the Workforce, for a period to be subsequently determined by...
  3. 26 original cosponsors on the day of introduction
  4. Referred to the Subcommittee on Health.House
  5. Chellie Pingree cosponsored (D-ME)
  6. Summer L. Lee cosponsored (D-PA)
  7. Steve Cohen cosponsored (D-TN)
  8. Sheila Cherfilus-McCormick cosponsored (D-FL)
  9. Referred to the Subcommittee on Health.House

Votes on this bill

No recorded votes yet on this measure.

Cosponsors

30 cosponsored

Sponsor Introduced by Ro Khanna (D-CA) on Nov 7, 2023

MemberParty/StateDateDays after introductionOriginalGrade
Adam B. SchiffD-CANov 7, 20230Original—
Adam SmithD-WANov 7, 20230OriginalB+
Andrea SalinasD-ORNov 7, 20230OriginalB+
Ayanna PressleyD-MANov 7, 20230OriginalB
Barbara LeeD-CANov 7, 20230Original—
Becca BalintD-VTNov 7, 20230OriginalB
Bonnie Watson ColemanD-NJNov 7, 20230OriginalB+
Cori BushD-MONov 7, 20230Original—
Dean PhillipsD-MNNov 7, 20230Original—
Delia C. RamirezD-ILNov 7, 20230OriginalB+
Earl BlumenauerD-ORNov 7, 20230Original—
Eleanor Holmes NortonD-DCNov 7, 20230Original—
Ilhan OmarD-MNNov 7, 20230OriginalA+
Jamaal BowmanD-NYNov 7, 20230Original—
James P. McGovernD-MANov 7, 20230OriginalB+
Janice D. SchakowskyD-ILNov 7, 20230OriginalA+
Jared HuffmanD-CANov 7, 20230OriginalB+
Jesus G. "Chuy" GarciaD-ILNov 7, 20230OriginalB
Joe NeguseD-CONov 7, 20230OriginalC
Mark PocanD-WINov 7, 20230OriginalA+
Pramila JayapalD-WANov 7, 20230OriginalA+
Rashida TlaibD-MINov 7, 20230OriginalA+
Raúl M. GrijalvaD-AZNov 7, 20230Original—
Shri ThanedarD-MINov 7, 20230OriginalA
Suzanne BonamiciD-ORNov 7, 20230OriginalB+
Val T. HoyleD-ORNov 7, 20230OriginalB
Chellie PingreeD-MENov 21, 202314A-
Summer L. LeeD-PADec 7, 202330B+
Steve CohenD-TNDec 12, 202335A
Sheila Cherfilus-McCormickD-FLOct 8, 2024336B+

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.