State Public Option Act

Key Points

• This bill allows states to create a new health insurance choice by letting residents buy into the Medicaid program. This 'public option' would provide an alternative to private insurance plans for people who do not currently have coverage.
• People who join this plan would pay monthly premiums and other costs like deductibles. However, the bill limits total premiums to no more than 8.5% of a family's income to keep it affordable. Financial help, such as tax credits, would also be available to help lower-income families pay for the plan.
• The insurance would cover a wide range of medical needs, including primary care, hospital visits, and reproductive health services. It specifically requires coverage for sexual and reproductive health care, including abortion services.
• To ensure patients can find a doctor, the bill increases the amount Medicaid pays for primary care visits so it matches the higher rates paid by Medicare. This is intended to encourage more doctors to accept patients from this new plan.
• If the bill becomes law, states could start offering this new insurance option as early as January 1, 2026. The federal government would pay for 90% of the administrative costs to help states set up and run the program.