Could States Implement Single Payer Health Care?

by Ben Cohen

Ezra Klein picks up on an interesting amendment to the healthcare bill that member of the Finance committee, Ron Wyden

introduced (which Max Baucus apparently accepted before the hearings even

began). Writes Klein:

The Wyden folks quietly slipped in an amendment

giving states enormous flexibility to experiment upward. Essentially,

states can ask the federal government for a waiver that allows them to

keep the federal funds they’re receiving and do pretty much anything

they want with them, so long as the coverage they provide is “at least

as comprehensive as required under the Chairman’s Mark” and will “lower

health care spending growth, improve the delivery system performance,

provide affordable choices for all its citizens, expand protections

against excessive out-of-pocket spending, provides coverage to the same

number of uninsured and not increase the Federal deficit.”

This could potentially pave the way for robust public options, or even single payer systems in individual states. While it could of course go the other way, Klein points out that, “since the amendment doesn’t allow anything to drift beneath the levels

envisioned in the bill itself, it’s hard to imagine a conservative

state using it to be any less generous than the state would otherwise


The language of the provision (see the hyperlink above) is confusing, so it’s most definitely up for interpretation. However, it is a potential caveat that could reap enormous reward should a brave governor decide to take matters into their own hands.

Ben Cohen is the editor and founder of The Daily Banter. He lives in Washington DC where he does podcasts, teaches Martial Arts, and tries to be a good father. He would be extremely disturbed if you took him too seriously.