State Public Option Act

# State Public Option Act Summary **What the bill would do:** The State Public Option Act would allow states to offer a Medicaid health insurance plan to uninsured residents starting in 2026. People who don't already have health coverage and aren't eligible for Medicaid could buy into their state's Medicaid program, with each state setting its own premiums and out-of-pocket costs. The bill also provides additional federal funding to states that expand Medicaid eligibility under the Affordable Care Act, regardless of timing, and requires state Medicaid programs to cover comprehensive sexual and reproductive health services, including abortion. **Who it affects:** This bill primarily affects uninsured Americans who fall into a coverage gap—those who don't qualify for Medicaid but can't afford private insurance.

It would also impact states' Medicaid programs and budgets, as states could choose whether to participate. Healthcare providers would potentially see changes in patient coverage types. **Current status:** The bill was introduced by Senator Brian Schatz (D-HI) in the 119th Congress and is currently in committee, meaning it hasn't advanced to a full Senate vote. No timeline for further action has been announced.