Shaheen, Schatz, Luján Reintroduce Legislation to Create Public Health Insurance Option, Provide More People with Affordable Health Care

August 10, 2021

(Washington, DC) – U.S. Senators Jeanne Shaheen (D-NH), Brian Schatz (D-HI) and Ben Ray Luján (D-NM) reintroduced the State Public Option Act, bicameral legislation to create a Medicaid-based public health insurance option to strengthen the Affordable Care Act by providing Americans with a new high-quality, low-cost choice when purchasing health insurance.

“The COVID-19 pandemic underscored the urgent need to expand access to high-quality and affordable health care coverage to all Americans,” said Senator Shaheen. “My bill with Senators Schatz and Lujan would create a public health care option by allowing residents to enroll in their state’s Medicaid program, providing flexibility for families while also lowering costs. I’ll keep fighting for policies and legislation that ensure every Granite Stater can afford the access to the care that they need.”

The State Public Option Act will allow states to create a Medicaid buy-in program for all their residents regardless of income, giving everyone the option to buy into a state-driven Medicaid health insurance plan. At least 18 states are exploring implementing a public option within their legislatures. Medicaid is a popular and cost-effective program with a large provider network. The program has the same positive ratings as private insurance, but provides health coverage at a much lower cost. Based on partnerships between state and federal governments, Medicaid also gives states the flexibility to adapt services and models of care based on their individual needs. 

Even with the progress of the Affordable Care Act (ACA), more than 30 million people remain uninsured. This legislation will help workers who do not have employer-sponsored coverage but may make too much to qualify for subsidies under the ACA. The bill will also help consumers who live in counties with limited insurance carriers or who worry they may soon have no options for affordable coverage.

In the Senate, the legislation is also cosponsored by U.S. Senators Elizabeth Warren (D-MA), Amy Klobuchar (D-MN), Jeff Merkley (D-OR), Martin Heinrich (D-NM), Jack Reed (D-RI), Tina Smith (D-MN), Jacky Rosen (D-NV), Mazie K. Hirono (D-HI), Richard Blumenthal (D-CT), Cory Booker (D-NJ), Ed Markey (D-MA), Kirsten Gillibrand (D-NY), Patrick Leahy (D-VT), Dick Durbin (D-IL), Chris Murphy (D-CT) and Sheldon Whitehouse (D-RI).

In the House, companion legislation was introduced by U.S. Representative Kim Schrier (D-WA), Dwight Evans (D-PA), Ruben Gallego (D-AZ), Betty McCollum (D-MN), Eric Swalwell (D-CA), Peter Welch (D-VT), Steve Cohen (D-TN), Paul Tonko (D-NY), Mike Doyle (D-PA), Eleanor Holmes Norton (D-DC), Doris Matsui (D-CA), Ilhan Omar (D-MN), Gwen Moore (D-WI), Dean Phillips (D-MN), and Pete Aguilar (D-CA). 

A summary of the bill is available here. The full text of the State Public Option Act is available here.

Shaheen has led efforts in Congress to protect and improve the Affordable Care Act, including leading all 47 Senate Democrats on a Senate resolution that would reverse the Department of Justice’s decision to side with U.S. District Court Judge Reed O’Connor’s ruling that would strike down the health care law. Senator Shaheen also spearheaded Senate Democrats’ proposal to make health care affordable and accessible for Americans during the COVID-19 public health emergency. During negotiations around the American Rescue Plan, Senator Shaheen led the push to expand and enhance the ACA’s premium tax credits – and thanks to her advocacy, provisions of her bill, the Improving Health Insurance Affordability Act, were included in the American Rescue Plan on a temporary basis. These changes are projected to reduce premium expenses by more than 37 percent on average. Consistent with Shaheen’s bill, President Biden’s American Families Plan would make these premium tax credit enhancements permanent, expanding health care coverage to more than 4 million Americans who would otherwise go uninsured.