Universal Healthcare Act:
A Public Option With Guaranteed Care
Every American will have the freedom to choose coverage through the public plan or a private plan, and all plans must meet the same standard of care so no one is left behind.
Key Principles
Healthcare is a right
- Public or private choice
- Rural communities first
- Shutdown-proof coverage
- Built with public participation
Introduction
Healthcare in the United States is no longer stable. It has been turned into a bargaining tool controlled by political leverage, shutdown threats, and partisan fights. The people who work for a living and raise families in rural communities are the first to absorb the impact. The Universal Healthcare Act is being drafted to ensure that every American will have a path to guaranteed care that cannot be taken hostage during a budget fight or a change in political power.
This legislation does not replace choice. It protects choice. Americans will be able to choose the public plan or a private plan, but every plan will be required to meet the same standard of care. No insurer will be permitted to sell a weaker or stripped down version of healthcare access. The public plan exists as a guarantee so that no one can be pushed out of care because of job loss, corporate withdrawal, or a political shutdown.
This Act is being built from the ground up, not the top down. It begins in rural and Tribal communities that have been left behind in the current system. Hospitals cannot remain open when funding depends on population density. A parity formula corrects the disadvantage built into rural healthcare delivery so that communities are no longer penalized for having fewer taxpayers per square mile.
TITLE I — Purpose, Findings, and Definitions
Title I establishes healthcare as a federally protected right under the General Welfare Clause. It recognizes that access to care cannot depend on employment, income, or private insurance markets. The findings section identifies political hostage tactics as a threat to public well-being and affirms that healthcare must remain stable during shutdowns, debt standoffs, or appropriations disputes. Definitions clarify eligibility and the scope of the right.
TITLE II — Guaranteed Care and Covered Services
Title II affirms that every citizen and lawful resident shall have the right to receive care. Covered services include primary care, emergency services, hospital care, prescriptions, maternal care, pediatric care, dental care, vision care, rehabilitation services, and mental health care at full legal parity with physical health. No copays or deductibles apply to guaranteed care. Continuity of care is protected so treatment cannot be interrupted due to political dispute or administrative transition.
TITLE III — Rural and Frontier Infrastructure
Title III recognizes that rural and Tribal communities face structural disadvantages in healthcare access. A Frontier Parity Multiplier ensures funding parity between rural regions and population-dense areas. Hospitals and clinics in rural regions are protected from closure when profitability declines, since access is not a market commodity. Telehealth, mobile care, and workforce incentives are built into the parity structure so care remains available across distance and geography.
TITLE IV — Financing and Administration
Title IV creates a national healthcare trust to serve as the payer of record. Individuals buy into the public plan through a sliding scale so no one is priced out. Employers may choose to enroll employees in the public plan instead of purchasing private coverage. Private insurers may still offer competing plans but must match or exceed the protections and services of the public plan. Price transparency is required for private carriers offering public-equivalent plans.
Public Participation and Drafting Process
As updated, the full bill draft will appear here. The Universal Healthcare Act is being drafted through public participation and community testimony. Stakeholder engagement will take place across Montana through listening sessions with workers, healthcare providers, Tribal governments, rural leaders, families, and those directly affected by coverage loss or service collapse.
This Act will be written with the people it serves and will not be shaped behind closed doors.
Montanans are invited to share lived experience, recommendations, and feedback during the drafting period. Testimony will inform final bill language before introduction in the United States Senate.
To participate in the process, contact info@reillyformontana.com.