Other countries think U.S. health care is both expensive and barbaric. They are right.

Ask your legislators to support the State-Based Universal Health Care (SBUHC) Act of 2021

  • Action #1: Call your House Representative to be cosponsors. A call takes less than a minute.
  • Action #2: Email a letter your House representative and their aides to be cosponsors. (Sample letter included)  

AB 1400-CalCare, CA’s latest single-payer proposal to fix for our bloated, yet cruelly inadequate health care system, has been temporarily placed on hold over the question of funding, including whether or not the federal government would grant us a waiver to obtain control over our Medicare and Medicaid costs. (Statement by Asm. Kalra)

However, Rep. Ro Khanna has just introduced a federal bill that would provide the answer – the State-Based Universal Health Care (SBUHC) Act of 2021, which would allow states to use their Medicare and Medicaid funds for a statewide healthcare system. It also requires that the state system covers at least 95% of its residents. PNHP-CA (Physicians for a National Health Program) supports this legislation.

Action #1: Call your House Representative to be cosponsors. A call takes less than a minute. 

Minimal call script: I’m calling from [zip code] and I want Rep. [___] to cosponsor and support Rep. Khanna’s State-Based Universal Health Care (SBUHC) Act of 2021, allowing [CA] to enact a single-payer system with Medicare and Medicaid funding.


  • Rep. Julia Brownley: email(CA-26): DC (202) 225-5811, Oxnard (805) 379-1779, T.O. (805) 379-1779
  • or Rep. Salud Carbajal: email.(CA-24): DC (202) 225-3601, SB (805) 730-1710 SLO (805) 546-8348
  • Who is my representative: https://whoismyrepresentative.com

Action #2: Email your House representative AND their legislative aides.

(This sample letter is adapted from this link by One Payer States, an organization supporting state level single payer. If you are a health professional, or can get your doctor to join in…two extra credit points! This is just a sample. Try to use your own voice and your own experiences with health care.)

Sample email script:

Rep. [___],

[(This line is for HR 1976 cosponsors only! Check here: Carbajal signed on, Brownley didn’t.) First, thank you for being an original cosponsor of HR 1976 – “To establish an improved Medicare for All national health insurance program.” Now we need you to go further.]

Please sign on as an cosponsor of Rep. Ro Khanna’s State Based Universal Healthcare Act of 2021 (SBUHC).

We know, that in comparison to other first-world countries, the US is behind on providing affordable access to health care. [(Put in a personal example here about how the cost/accessibility of health care affects you or your loved ones or general examples: Poor people die years sooner with treatable conditions. We have medical bankruptcies. Diabetics die for lack of affordable insulin, copays too high, etc…] Covid 19 has exposed the cruel inequities and unsustainability of our current fractured healthcare system, and it is time that our country takes significant steps to catch up with the rest of the world. We need a universal national plan that includes everyone, but we should also support state initiatives to expand comprehensive healthcare. States have served as the incubators for lasting systemic change, and it is our belief that we can do so again with healthcare reform. 

Rep. Ro Khanna’s bill would amend the ACA by creating a waiver to allow states to develop their own plans. In fact, multiple states are already passing legislation to ready themselves for a transition to a unified financing system pending federal authority. [(Talk about your own state) CA’s own AB 1400 was temporarily withdrawn over the uncertainty of gaining this kind of financial support.]

The State Based Universal Health Care Act requires participating states or groups of states to propose plans to provide health care coverage for at least 95 percent of their residents within five years, and requires benefits provided under state plans be equal to or greater than what federal beneficiaries receive now. Section 1332 of the ACA already allow states to innovate, but experts say that the 1332 waivers don’t quite go far enough. Here are the main reasons the State Based Universal Health Care Act 1335 waiver is different from, and better than, the ACA’s 1332 waiver for the purposes of creating universal state plans:

  • SBUHC allows states to integrate Medicare funds into a state plan; ACA’s 1332 does not.
  • SBUHC gives access to an ERISA waiver to prevent self-insured employers from opting out of a state plan; 1332 does not.
  • SBUHC allows two or more states to apply for waivers together to create a regional plan; 1332 does not.
  • SBUHC requires state plans to cover at least 95% of their residents within 5 years; 1332 does not.
  • SBUHC creates a broad HHS Secretary-appointed Independent Assessment Panel to review and recommend on 1335 waiver applications; 1332 leaves waiver decisions with the HHS Secretary alone.

Please sign on as an cosponsor of this critical legislation as we look to our leadership in the most challenging time we’ve faced in generations. This is a commonsense solution to increasing health care accessibility to more of your constituents, which ultimately creates better patient outcomes and lower costs. you will take this opportunity to be an original cosponsor of Ro Khanna’s bill that would facilitate state based single payer reform for the people of California.




Additional interesting resources

This is 50 minutes, but well worth it.

  • (pnhp.org) A Brief History: Universal Health Care Efforts in the US
  • Here are some resources from the One Payer States site:
    • Why you don’t need Medicare “Advantage” plans and how they cause more harm than good:   tinyurl.com/yc6uahlx 2:57 min.
    • Why avoiding Part D Plans until you need a brand-name drug is a good idea and will save you money:   tinyurl.com/ycgcyect  7:50 min.
    • Why employer-based self-insurance sounds like a good deal for employers but isn’t: tinyurl.com/y9knjv5l  6:55 min.
    • Why insurance companies rush to manage high-risk programs like Medicare and Medicaid:  tinyurl.com/y7ukzegn  3:46 min.
    • Hint: Insurance companies don’t worry about pre-existing conditions when they administer public programs because we the public still bear the ultimate risk. Administrative overhead for Medicare Advantage is 10% versus 3% for Traditional Medicare. For other private health insurance the overhead is 10-30%.
    • Save and expand Traditional Medicare:   tinyurl.com/y8exmft8  6:12 min.ace holder 
    • Full 60 minute video by Dr. Belk on the failures of private health insurance:  https://youtu.be/z6kmZu1p5MQ?t=2THE US HEALTH CARE SYSTEM IS NOT A SYSTEM https://www.youtube.com/watch?v=23lq7znnQpk

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