Is it possible that broader health coverage could come through state action instead of national action?

The Hill reports that Representative Ro Khanna, D-California, has offered a bill that would let states apply for waivers from the federal government to pool the federal funds they already receive to set up a single-payer system.

Federal funds for such programs as Medicare, Medicaid and the Affordable Care Act could then be combined to allow the states with such waivers to become "early adopters" of a Medicare for All system, much as the province of Saskatchewan in Canada led the way north of the border.

Saskatchewan adopted its own version of government-run health insurance back in 1947, long before the Canadian government extended inclusive care to the rest of the country.

While there's currently zero chance of Khanna's bill making it through a Republican-controlled Senate, much less to a signature in the Oval Office, it could pave the way toward a Medicare for All configuration that would be more acceptable to more conservative Democrats if 2020 sees another "blue wave" that takes over the Senate and the White House.

The bill, which already has 15 cosponsors in the House, would be another run at single-payer on the other end of the country from Vermont, which made its own attempt at the state level. However, that effort succumbed in 2014 to a failure to find a way to pay for it.

Supporters say that in a bigger state like California, however, Khanna's plan could be made to work.

In a statement, Khanna said, "While Senator McConnell and President Trump do all they can to obstruct progress at the federal level, this bill allows states with bold leadership to establish their own successful universal health care programs in order to prove how viable our movement is on the national level. This is how bold states like California can take the lead in making Medicare for All a reality."

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House Democrat offers state-based Medicare for All bill

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