State Public Option Act
State Public Option Act
Plain Language Summary
# State Public Option Act Summary **What It Would Do** The State Public Option Act would allow states to offer a "public option" — a government-run health insurance plan based on Medicaid — that uninsured people could buy into starting in 2026. States would have the choice whether to participate. The bill also sweetens the financial incentive for states to expand Medicaid by guaranteeing them higher federal funding rates, regardless of when they expand. Additionally, it would require state Medicaid programs to cover sexual and reproductive health services, including abortion. **Who It Affects** This bill primarily affects uninsured Americans who don't qualify for Medicaid, people in states that haven't expanded Medicaid, and state governments that would decide whether to offer the public option.
It could also affect healthcare providers and pharmaceutical companies serving Medicaid patients. **Current Status** The bill (HR 3995) is currently in committee and has not yet advanced to a full House vote. It was introduced by Rep. Kim Schrier, a Democrat from Washington state, during the 119th Congress.
CRS Official Summary
State Public Option ActThis bill allows residents who are not already eligible for Medicaid and not concurrently enrolled in other health insurance coverage to buy into a state Medicaid plan beginning January 1, 2026, at the option of the state. State Medicaid programs may set premiums and cost-sharing requirements for such coverage in accordance with specified limitations.The bill also (1) provides the enhanced Federal Medical Assistance Percentage (i.e., federal matching rate) to every state that expands Medicaid coverage for individuals who are newly eligible under the Patient Protection and Affordable Care Act, regardless of when such expansion takes place; and (2) requires state Medicaid programs to cover comprehensive sexual and reproductive health care services, including abortion services.
Latest Action
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.