# 119-hr-4406: State-Based Universal Health Care Act of 2025

119-hr-4406, State-Based Universal Health Care Act of 2025, is a 119th Congress bill sponsored by Rep. Khanna, Ro [D-CA-17] (D-CA); status introduced; PRIA reads it as touching household money (as of 2026-07-19).

- Canonical: https://policyrisk.com/legislation/119-hr-4406
- As of: 2026-07-19
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Bill: 119-hr-4406
- Congress: 119
- Title: State-Based Universal Health Care Act of 2025
- Status: introduced
- Introduced: 2025-07-15
- Sponsor: Rep. Khanna, Ro [D-CA-17] (D-CA)
- Cosponsors: 35
- Policy area: Health
- Touches household money: yes
- Last recorded action: 2026-07-19

## Summary

**Would create a new federal waiver letting states run comprehensive universal health care plans with federal passthrough funding.** It would let states replace or supersede many federal rules while keeping requirements for coverage, affordability, and oversight.

## Cosponsors (35)

- Rep. Cherfilus-McCormick, Sheila [D-FL-20] (D-FL), 2025-07-15T00:00:00.000Z
- Rep. Cohen, Steve [D-TN-9] (D-TN), 2025-07-15T00:00:00.000Z
- Rep. McGovern, James P. [D-MA-2] (D-MA), 2025-07-15T00:00:00.000Z
- Del. Norton, Eleanor Holmes [D-DC-At Large] (D-DC), 2025-07-15T00:00:00.000Z
- Rep. Neguse, Joe [D-CO-2] (D-CO), 2025-07-15T00:00:00.000Z
- Rep. Omar, Ilhan [D-MN-5] (D-MN), 2025-07-15T00:00:00.000Z
- Rep. Pingree, Chellie [D-ME-1] (D-ME), 2025-07-15T00:00:00.000Z
- Rep. Salinas, Andrea [D-OR-6] (D-OR), 2025-07-15T00:00:00.000Z
- Rep. Smith, Adam [D-WA-9] (D-WA), 2025-07-15T00:00:00.000Z
- Rep. Thanedar, Shri [D-MI-13] (D-MI), 2025-07-15T00:00:00.000Z
- Rep. Huffman, Jared [D-CA-2] (D-CA), 2025-07-15T00:00:00.000Z
- Rep. Tlaib, Rashida [D-MI-12] (D-MI), 2025-07-15T00:00:00.000Z
- Rep. Watson Coleman, Bonnie [D-NJ-12] (D-NJ), 2025-07-15T00:00:00.000Z
- Rep. Jayapal, Pramila [D-WA-7] (D-WA), 2025-07-15T00:00:00.000Z
- Rep. Lee, Summer L. [D-PA-12] (D-PA), 2025-07-15T00:00:00.000Z
- Rep. Thompson, Bennie G. [D-MS-2] (D-MS), 2025-07-15T00:00:00.000Z
- Rep. Ansari, Yassamin [D-AZ-3] (D-AZ), 2025-07-15T00:00:00.000Z
- Rep. Bonamici, Suzanne [D-OR-1] (D-OR), 2025-07-15T00:00:00.000Z
- Rep. Nadler, Jerrold [D-NY-12] (D-NY), 2025-07-15T00:00:00.000Z
- Rep. Ramirez, Delia C. [D-IL-3] (D-IL), 2025-07-15T00:00:00.000Z
- Rep. Dexter, Maxine [D-OR-3] (D-OR), 2025-07-15T00:00:00.000Z
- Rep. Velázquez, Nydia M. [D-NY-7] (D-NY), 2025-07-15T00:00:00.000Z
- Rep. Schakowsky, Janice D. [D-IL-9] (D-IL), 2025-07-16T00:00:00.000Z
- Rep. Frost, Maxwell [D-FL-10] (D-FL), 2025-07-17T00:00:00.000Z
- Rep. Pocan, Mark [D-WI-2] (D-WI), 2025-07-17T00:00:00.000Z
- Rep. Stansbury, Melanie A. [D-NM-1] (D-NM), 2025-07-22T00:00:00.000Z
- Rep. Hoyle, Val T. [D-OR-4] (D-OR), 2025-07-29T00:00:00.000Z
- Rep. Clarke, Yvette D. [D-NY-9] (D-NY), 2025-08-08T00:00:00.000Z
- Rep. Pressley, Ayanna [D-MA-7] (D-MA), 2025-08-15T00:00:00.000Z
- Rep. Olszewski, Johnny [D-MD-2] (D-MD), 2025-09-26T00:00:00.000Z
- Rep. Bynum, Janelle S. [D-OR-5] (D-OR), 2025-10-28T00:00:00.000Z
- Rep. Deluzio, Christopher R. [D-PA-17] (D-PA), 2025-10-31T00:00:00.000Z
- Rep. Mfume, Kweisi [D-MD-7] (D-MD), 2026-01-15T00:00:00.000Z
- Rep. Randall, Emily [D-WA-6] (D-WA), 2026-02-23T00:00:00.000Z
- Rep. Balint, Becca [D-VT-At Large] (D-VT), 2026-07-02T00:00:00.000Z

## Provisions PRIA read

- Federal dollars would flow to state plans: benefit, high. If a State takes over federal health programs under a waiver, the federal government would stop paying those programs directly and would pay the State instead. The annual payment would reflect what the federal government would have spent, with adjustments for caseload growth and health care inflati…
- States could run universal plans in 2026: benefit, high. This bill would let a State ask federal officials for a waiver to run its own universal plan starting with plan years on or after January 1, 2026. The State would need legal authority, a 10-year federal‑budget‑neutral plan, and a plan to cover at least 95% of residents within five years. “Residents…
- Strong benefits and patient protections in state plans: benefit, high. The Secretary would approve a State plan only if it matches or improves on federal coverage, access, and costs. People who would have had Medicaid must get mandatory Medicaid benefits like EPSDT, non‑emergency transport, and retroactive coverage. The plan must cover all residents except people elig…
- Protections for American Indian health care: benefit, medium. States and plans using a waiver would not be allowed to charge American Indians and Alaska Natives premiums, copays, or other fees for covered services. The federal government would cover those waived costs. States could not force American Indians to enroll in waiver insurance. Plans would need to…
- States would need to reach 95% coverage: mixed, high. Every five years, a State with a waiver would need an independent report on spending, affordability, quality, access, and how many people are uninsured. The State would need to reach at least 95% coverage of residents. If it falls short, the Secretary would provide help and a 12‑month grace period.…

## Related bills

- 119-hr-7973: Momnibus Act
- 119-hr-7977: Energy Bills Relief Act
- 119-hr-51: Washington, D.C. Admission Act
- 119-hr-20: Richard L. Trumka Protecting the Right to Organize Act of 2025
- 119-hr-8800: National Defense Authorization Act for Fiscal Year 2027
- 119-hr-5390: FAMILY Act

## Sources
- [119-hr-4406 on Congress.gov](https://www.congress.gov/bill/119th-congress/house-bill/4406)

## Related
- [119-hr-7973: Momnibus Act](https://policyrisk.com/legislation/119-hr-7973)
- [119-hr-7977: Energy Bills Relief Act](https://policyrisk.com/legislation/119-hr-7977)
- [119-hr-51: Washington, D.C. Admission Act](https://policyrisk.com/legislation/119-hr-51)
- [119-hr-20: Richard L. Trumka Protecting the Right to Organize Act of 2025](https://policyrisk.com/legislation/119-hr-20)
- [119-hr-8800: National Defense Authorization Act for Fiscal Year 2027](https://policyrisk.com/legislation/119-hr-8800)
- [119-hr-5390: FAMILY Act](https://policyrisk.com/legislation/119-hr-5390)
- [All bills in Congress](https://policyrisk.com/legislation)

Source: PRIA, https://policyrisk.com/legislation/119-hr-4406 (as of 2026-07-19).