# 119-s-2286: State-Based Universal Health Care Act of 2025

119-s-2286, State-Based Universal Health Care Act of 2025, is a 119th Congress bill sponsored by Sen. Markey, Edward J. [D-MA] (D-MA); status introduced; PRIA reads it as touching household money (as of 2025-12-21).

- Canonical: https://policyrisk.com/legislation/119-s-2286
- As of: 2025-12-21
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Bill: 119-s-2286
- Congress: 119
- Title: State-Based Universal Health Care Act of 2025
- Status: introduced
- Introduced: 2025-07-15
- Sponsor: Sen. Markey, Edward J. [D-MA] (D-MA)
- Cosponsors: 3
- Policy area: Health
- Touches household money: yes
- Last recorded action: 2025-12-21

## Summary

This bill would create a framework letting states implement **state-based universal health care plans** while requiring federal budget neutrality and a 95 percent coverage goal within five years. - States: Would be able to apply for waivers to run comprehensive state plans that must be budget neutral for the Federal government and include a plan to reach 95 percent coverage within 5 years. - Residents and families: Would get coverage that must be at least as comprehensive and as affordable as comparable Federal programs and must include reproductive and gender-affirming care. - American Indian and Alaska Native communities: Would receive special protections that bar premiums, deductibles, copays, or similar charges for Indian individuals and require good-faith contracting and payment rules for Indian health care providers.

## Cosponsors (3)

- Sen. Warren, Elizabeth [D-MA] (D-MA), 2025-07-15T00:00:00.000Z
- Sen. Merkley, Jeff [D-OR] (D-OR), 2025-07-15T00:00:00.000Z
- Sen. Padilla, Alex [D-CA] (D-CA), 2025-07-15T00:00:00.000Z

## Provisions PRIA read

- State plans must match federal protections: benefit, high. If enacted, an approved State plan would have to provide coverage at least as comprehensive and affordable as the federal programs it replaces. For Medicaid-related waivers that means mandatory Title XIX benefits like EPSDT, non‑emergency transportation, and retroactive coverage. The plan would nee…
- Stronger protections for Native health: benefit, medium. If enacted, the Secretary would have to issue rules to protect American Indian and Alaska Native people under waivers. The rules would ban enrollment fees, premiums, deductibles, copays, and similar charges for Indians for services under a waiver, with the federal government covering those waived c…
- States can apply for universal health waivers: mixed, high. If enacted, a State could apply for a federal waiver to run a statewide universal health plan for plan years starting Jan 1, 2026. Applications would need state legal authority and a 10‑fiscal‑year budget plan that is budget neutral for the federal government. The waiver would only apply to the fed…
- Federal funding passthrough to States: mixed, high. If enacted, when a State takes over covered federal health programs the federal government would stop spending program funds directly and instead pay the State an annual aggregate amount. That amount must include funds equal to premium tax credits, cost‑sharing reductions, and small‑business credit…
- New federal waiver review and coordination: mixed, low. If enacted, HHS, Treasury, Defense, Labor, and OPM would have to adopt a single coordinated waiver process within 180 days so States can submit one application and rules line up. The bill would also create an 11‑member independent panel to review waiver applications and 5‑year reports and give reco…

## Related bills

- 119-s-5066: Health Equity and Accountability Act of 2026
- 119-s-5022: Cannabis Administration and Opportunity Act
- 119-s-2819: Head Start for America's Children Act
- 119-s-3990: PrEP Access and Coverage Act of 2026
- 119-s-2823: FAMILY Act
- 119-s-2763: Keep Billionaires Out of Social Security Act

## Sources
- [119-s-2286 on Congress.gov](https://www.congress.gov/bill/119th-congress/senate-bill/2286)

## Related
- [119-s-5066: Health Equity and Accountability Act of 2026](https://policyrisk.com/legislation/119-s-5066)
- [119-s-5022: Cannabis Administration and Opportunity Act](https://policyrisk.com/legislation/119-s-5022)
- [119-s-2819: Head Start for America's Children Act](https://policyrisk.com/legislation/119-s-2819)
- [119-s-3990: PrEP Access and Coverage Act of 2026](https://policyrisk.com/legislation/119-s-3990)
- [119-s-2823: FAMILY Act](https://policyrisk.com/legislation/119-s-2823)
- [119-s-2763: Keep Billionaires Out of Social Security Act](https://policyrisk.com/legislation/119-s-2763)
- [All bills in Congress](https://policyrisk.com/legislation)

Source: PRIA, https://policyrisk.com/legislation/119-s-2286 (as of 2025-12-21).