Summary of HR 4406: State-Based Universal Health Care Systems Act

Bill Overview

Bill Number: HR 4406

Title: To amend title I of the Patient Protection and Affordable Care Act to authorize the establishment of, and provide support for, State-based universal health care systems that provide comprehensive health benefits to State residents, and for other purposes.

Status: Introduced in House

Introduced Date: July 15, 2025

Purpose and Intent

The primary aim of HR 4406 is to empower states to create and implement their own universal health care systems. This legislation seeks to ensure that all state residents have access to comprehensive health benefits, thereby enhancing the overall health care landscape in the United States. By amending the Patient Protection and Affordable Care Act (ACA), the bill intends to provide a framework and support for states pursuing universal health care initiatives.

Key Provisions

• Authorization for State Systems: The bill allows states to establish their own universal health care systems, which must provide comprehensive health benefits to all residents.
• Support Mechanisms: It includes provisions for federal support to assist states in developing and maintaining these health care systems.
• Comprehensive Benefits: The legislation emphasizes that the health care systems must cover a wide range of health services, ensuring that residents receive necessary medical care without financial barriers.

Affected Parties

• State Governments: States will have the authority to design and implement their own health care systems, which may lead to variations in health care delivery and coverage across the country.
• Residents of States: All state residents will be eligible for comprehensive health benefits under these systems, potentially improving access to health care services.
• Health Care Providers: Providers may need to adapt to new systems and regulations as states implement their universal health care models.

Legislative Process

• Committee Referral: Upon introduction, HR 4406 was referred to the Committee on Energy and Commerce, along with additional committees including Armed Services, Ways and Means, Oversight and Government Reform, and Education and Workforce. Each committee will review the bill for provisions relevant to their jurisdiction.
• Timeline: The specific timeline for committee consideration and further legislative action has yet to be determined by the Speaker of the House.

Sponsors

The bill is sponsored by Representative Ro Khanna and has numerous cosponsors, including:
- Joe Neguse
- Yassamin Ansari
- Maxine Dexter
- Delia C. Ramirez
- Mark Pocan
- Andrea Salinas
- Adam Smith
- Eleanor Holmes Norton
- Pramila Jayapal
- Chellie Pingree
- Sheila Cherfilus-McCormick
- Suzanne Bonamici
- Nydia M. Velázquez
- Bennie G. Thompson
- Jared Huffman
- Janice D. Schakowsky
- Shri Thanedar
- James P. McGovern
- Jerrold Nadler
- Ilhan Omar
- Summer L. Lee
- Steve Cohen
- Rashida Tlaib
- Maxwell Frost
- Bonnie Watson Coleman

Conclusion

HR 4406 represents a significant step towards expanding health care access in the United States by allowing states to create their own universal health care systems. If enacted, this legislation could lead to transformative changes in how health care is delivered and financed at the state level, potentially improving health outcomes for millions of Americans.