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# Summary This bill creates a new federal waiver process that allows states to establish universal health care systems covering all their residents. Under the legislation, states may apply to the federal government for permission to waive federal health care requirements and consolidate funding from existing programs—including Medicare, Medicaid, the Children's Health Insurance Program, federal employee health benefits, and military health coverage—into a single state-administered universal plan. States must demonstrate that their plan will cover at least 95 percent of residents within five years, provide comprehensive benefits equivalent to current federal coverage, protect residents against excessive out-of-pocket costs, and remain budget-neutral to the federal government over a 10-year period. The bill establishes an independent review panel to evaluate state applications and requires states to submit progress reports every five years, with federal funding adjustments made annually based on what would have been spent under existing programs. States that fail to meet the 95 percent coverage target get a 12-month grace period and access to technical assistance before the federal government can terminate their waiver.

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