Universal Health Care Legislation:
History and Archive, 1975 to 2004

CA

SB 2 - Enacts the Health Insurance Act of 2003, creating the State Health Purchasing Program. The bill requires specified health benefits to be provided directly by employers or through the program. The bill requires the board to arrange health plan coverage for certain employers, who would be required to pay a fee for employee health coverage, except that employers who provide health care coverage directly would receive a credit against the fee. The bill requires employees and dependents of large employers to be covered beginning January 1, 2006, while it requires employees of medium employers to be covered beginning January 1, 2007, subject to certain conditions. Small employers are exempted from the requirement to provide coverage and from the fee. The bill requires the board to determine the fee to be paid by employers, and provides that the associated employee contributions, which employers would be required to collect from employees, may not exceed 20 percent of the employer fee. It would be administered by Managed Risk Medical Insurance Board (MRMIB.) Failed

This law is operative in conjunction with AB 1528 (by Assemblymember Cohn) requiring the Governor to convene the California Health Care Quality Improvement and Cost Containment Commission (Commission) composed of 27 members.

(SB 2 and AB 1528 both passed by the Assembly and Senate 6/12/03; signed by governor 10/5/03)
UPDATE:  This law was repealed by ballot referendum on November 2, 2004.
Articles & analyses:  Governor Signs Bill 10/6/03. || Employers’ Responses To A Play-Or-PayMandate: An Analysis Of California’s Health Insurance Act Of 2003 - Health Affairs, 10/04 ||
California Case Study: What can we learn from California’s experience of SB 2 - 10/04.

CA

AB1527 - Would create a "pay or play" system under which an employer with 51 or more employees is required either to provide quality health care coverage that includes prescription drug benefits for his or her employees and their dependents or to pay a fee so that his or her employees and their dependents may obtain coverage from a statewide pool. (b) Establishing a purchasing pool to be operated by the Managed Risk Medical Insurance Board to provide health care coverage for employees and their dependents of employers who do not provide coverage directly. (c) Maximizing federal financial participation in health care coverage for individuals eligible for the Healthy Families Program and the Medi-Cal program through a premium assistance program that allows eligible employees to enroll in employment-based health coverage with reimbursement from the state for the employee's share of the premium and for the cost of any benefits or services required by those programs that are not covered under the employer's plan. (d) Providing assistance to small employers for the cost of providing coverage to their employees and to employees who cannot afford their share of the premium costs. For those employers who are not subject to the "pay or play" requirements, assistance would be intended to serve as an incentive to purchase coverage.
(Passed Assembly 6/9/03; changed in Conference - see SB 2 above)
Advocacy description by Health Access California

CA

SB 921 - Would create a single payer health system termed the Health Care for All Californians Act.
(Filed 1/03; passed Senate 6/4/03; changed/did not pass - see SB 2 above)

SB 73 - Comprehensive state health care reform for the purpose of access to health care for all Colorado residents.
(Last Action February 13, 2004)

SB 418 - Establishes a board to oversee and implement a program to provide universal health care.
(Last Action March 16, 2004).

DE

HB 62 Would create the Delaware Health Security Act will provide all current and future Delaware citizens and our economy a non-government run program and cost effective single payer health care system. Funding for the Delaware Health Security Act will be as follows: All State and federal funds available for health and health care costs in Delaware. Employer and employee graduated payroll tax of from 2% for self-employed individuals to 9% for businesses with 50 or more employees. A Health Security Tax of 2.5% on net taxable income for all heads of households and persons subject to Delaware's income tax. For people over $250,000 annual income, an additional income surtax on net taxable income of 2.5%.
(Filed 3/13/03; did not pass by end of '03 session-carryover; held in committee as of 5/04)

FL

HB 109/ SB 2074 Would create "Health Care that Works for All Floridians Act"; establishes Citizens' Health Care Working Group; provides for membership & criteria therefor; provides for term of membership; requires public hearings; provides for community health care meetings & for dissemination of recommendations; provides for staff of working group; requires report to Legislature.
(Senate: Filed 3/4/03; died in committee 5/2/03)

GA

HB 130 would create the "Georgia Health Care Act" which establishes the Georgia health care corporation as a public corporation to implement and administer the Georgia health plan. The plan is a single-payer health insurance coverage system.
(The bill did not pass in 2003)

HB 2008; HB2125 - Establishes a system of universal health care insurance in the State of Hawaii.
(Last action February 13, 2004)

HI

S 1676 & H 1617 - Would create a single payer health system, with the state health authority "shall have broad powers to purchase health care for all of Hawaii's citizens." The authority shall develop a plan that includes: Providing state-funded health insurance for all individuals; Maximizing federal funds;

Adopting all optional services allowed under the Medicaid programs; Reimbursing all certified health care providers at a rate to be determined by the authority within thirty days of the provision of care; and Collecting or receiving on a monthly basis all insurance of any kind that includes coverage for health care: individual and/or employer contributions through the financing mechanism established by the commission; federal Medicaid matching funds; state general fund appropriations; and individual monthly dues and the medical payment portions of automobile insurance policy premiums, public liability insurance premiums; and homeowners insurance policy premiums. States that "The legislature believes that while the Prepaid Health Care Act served its purpose during the time it was created and for many years thereafter, it is now time to consider other options. Increasing health care costs, insurance premiums, employer costs, prescription drug costs, and long-term care costs, together with the growing number of uninsured individuals and inadequate Medicaid reimbursements, are creating a need for new and innovative legislation that will provide affordable health care for all of Hawaii's citizens."
(Filed 1/2003; Passed Senate 3/4/03; did not pass by end of '03 session; carryover to '04)

IL

SCA 22 / SJR 22- Would amend the state constitution to state "Health care is an essential safeguard of human life and dignity, and there is an obligation for the State of Illinois to ensure that every person is able to realize this fundamental right. On or before May 31, 2006, the General Assembly by law shall enact a plan for universal health care coverage that permits everyone in Illinois to obtain decent health care on a regular basis."
(Filed and sent to committee 2/26/03)

IL

HB 2268 & SB 1430 - The Health Care Justice Act, would establish a four-year, bi-partisan process to gather information about health care needs in the state, study various proposed solutions and develop political consensus around a specific plan that must be voted on by the Legislature.
(Passed House, 5/03 & Senate committee; may be considered by the Senate in October 2003.)
Explanation by supporters, see : Campaign for Better Health Care

ME

LD 1611, signed as Chapter 469 Dirigo Health will seek to insure 31,000 individuals during its first year of operations, beginning July '04, and will provide access to coverage for at least another estimated 110,000 individuals by 2009. Coverage will be available to uninsured individuals, businesses and municipalities with 50 or fewer employees, and the self-employed.
Dirigo Health will offer affordable health care coverage and will provide subsidies to individuals and families on a sliding scale based on ability to pay - For example, individuals with gross income up to $27,000 and a family of 4 with an annual gross income of $55,000 would qualify for reduced fees on a sliding scale. Enrollees benefit from lower and more stable rates provided by participation in a larger group.
    Dirigo Health will offer coverage through private health insurance carriers to provide a comprehensive package of benefits and will pay providers at private insurance market rates - other services offered will include disease management, health promotion and prevention.    There will be strengthened oversight, review and approval of small and large group insurance rate filings by the Superintendent of Insurance, including in some cases, public hearings and actuarial reviews.  Hospitals will be required to maintain price lists and provide them to patients upon request. Health care practitioners will be required to notify patients in writing of their charges for common services.
    Health insurance carriers will be permitted to offer their enrollees financial incentives to travel further to undergo non-emergency surgical procedures if the carriers can demonstrate cost-effectiveness and that the quality of care is equal to or better in the more distant location(s).
One year voluntary caps on cost and operating margins of insurers, hospitals and health care providers will be requested during the first year. The first year of Dirigo Health will be funded with contributions from enrolled individuals and small businesses, federal matching funds for low-income families (those below 200% federal poverty guidelines), and with about $53 million in one-time Federal fiscal relief money.
    After the first year of operation, a "savings offset payment" by insurers and third party administrators will be paid in proportion to cost savings achieved. If there are no savings, no payment will be required. Savings will result from cost controls such as the CON moratorium, the voluntary price controls and decreases in bad debt and charity care costs. The Certificate of Need (CON) process has been strengthened to ensure more regulated development of health care services.
UPDATE: As of February 1, 2005, DirigoChoice has 2,700 members from across the State. Membership includes 250 small businesses and 1,000 self-employed workers.
(Signed by governor, 6/18/03)
2004-05 REPORTS:  
>  "DirigoChoice Enrollment Open for Individuals" by Maine Governor's Office, 2/05.
> "Dirigo Health Reform Act" by NASHP & Maine Govrenor's Office, 7/04. 
>  Maine Tries 'Voluntary' Socialized Health Care by Heartland Institute, 5/04.

MD

HB 726 - Would provide universal health care coverage for state residents by changing eligibility requirements in the Medicaid program, the Maryland Children's Health Program (MCHP), the Maryland Pharmacy Discount Program (MPDP), the Maryland Health Insurance Plan (MHIP), and the small group health insurance market. The bill would also impose insurance premium taxes on health maintenance organizations; alter the tobacco tax rate for cigarettes; and rename the Maryland Health Insurance Plan to be MD-Care.
(The bill died in the House on 3/14/03)

MA

S.686 & S. 655 to create the Massachusetts Health Care Trust single-payer health program.
In March, the Healthcare Committee substituted the following:
"The division of health care finance and policy shall study the fiscal impact, including the total cost of implementation, the potential long term costs and savings and an estimate of the amount of new state revenue necessary, if any, for implementation, of pending Senate Bill Number 686, establishing a Massachusetts health care trust.  The division shall report the results of its findings to the joint committee on health care by November 1, 2004."
(Substituted  study language in S.2272 , favorable committee report, 3/04; study passed Senate 5/4/04; in House)

MA

Proposed constitutional amendment initiative petition to advocate health insurance for all Massachusetts residents. If the signatures are approved, the petition must be passed by the next two constitutional conventions, or obtain a second round of signatures, before it reaches the 2006 ballot. Bill # to be assigned in 2004.
(Required petition signatures filed with the secretary of state 12/3/03)

MA

H 4444 of 2004 Proposed initiative constitutional amendment would establish a right to health insurance. "Upon ratification of this amendment and thereafter, it shall be the obligation and duty of the Legislature and executive officials, on behalf of the Commonwealth, to enact and implement such laws as will ensure that no Massachusetts resident lacks comprehensive, affordable and equitably financed health insurance coverage for all medically necessary preventive, acute and chronic health care and mental health care services, prescription drugs and devices."
(Initially passed in joint constitutional session, 153y-41n, 7/14/04.  Requires a second vote of approval during 2005-06 and voter approval on 2006 ballot.)

MN

H 1141, H 248 & S 979 - Would provide that "The commissioner of health shall establish a working group to design a universal health care system for Minnesota., with proposed legislation for submission to the legislature by January 31, 2006, to establish a universal health care system for Minnesota to take effect in January 2010. The proposed legislation must meet several requirements such as "ensure all Minnesotans receive comprehensive health care of the highest quality available, regardless of their income."
(Filed 4/1/03; did not pass in '03 session; carryover to '04)

MN

MO

SB 23 - would establish the "Missouri Universal Health Assurance Program" to provide health care benefits to all citizens in the state.
(bill filed on 12/01/02; did not pass)

NY

A 1071 - Would create a plan for a Single Payer universal health plan for New York. Provides that "The commissioners of the state insurance fund are authorized and directed to establish a single payer health care plan and are further authorized and directed to submit appropriate legislation to the legislature establishing such single payer health care plan for all residents of the state of New York within one hundred eighty days of the effective date of this act. The commissioners of the state insurance fund shall also submit a report detailing the cost savings of establishing the plan.
(Filed & sent to committee 1/14/03; no further action as of 9/03)

OR

H 2741 -Would create the 15 member Task Force on Universal Health Care Coverage, directed to develop a plan for universal health care coverage. Would require further legislation for implementation.
(Filed and sent to committee 2/28/03; did not pass in '03)

OR

HJR 21 - Would propose an amendment to Oregon Constitution declaring health care to be a fundamental right of every Oregon resident and directing the Legislature to enact legislation creating plan for universal health care coverage by 2007.
(Filed and sent to committee 2/28/03; did not pass in '03)

RI

H 6318 - Would create the "Rhode Island Health Care Single Payer Act."
(Filed and sent to committee 4/10/03; subject to carryover*)

WI

A 229 & S 90 - Would create a publicly financed universal health plan, under which each eligible person shall receive reasonable medical service necessary to maintain health, enable diagnosis, or provide treatment or rehabilitation for an injury. Would begin on July 1, 2006.
(Filed and sent to committee, 4/2/03; did not pass in '03 session, carryover to '04*)

IL

HCA 7 would amend the Bill of Rights Article of the Illinois Constitution to provide that the state enacts on or before May 31, 2004 a plan for universal health care coverage for all persons.
(Did not pass committee by end of session, 12/31/02)

ME

LD 1277 was a bill that proposed a single payer system.
LD 855 (budget bill), part zzz (Public Law 439) would create a legislative study to examine the feasibility of a single payer system. (Bill died in committee at the end of session, 6/02)

NY

A 4700 would authorize and direct the Commissioners of the State Insurance Fund to establish a single payer health care plan for all state residents and to submit appropriate legislation to the legislature. It also directs the commissioners to submit a report detailing the cost savings of a single payer health care plan as related to the existing costs of health care services in the state.
(Last action was on Feb. 13, 2001 when it was referred to the committee on insurance.)

RI

H 6025 would create the Rhode Island health care trust for the purposes of developing an infrastructure that creates a single payer system to pay for comprehensive health care services to all state residents.
(Last action was on Feb. 8, 2001 when it was referred to the House Committee on Finance.)

VT

Vermont has developed The Vermont Health Access Plan. [not new law] (see note below)