The catch is that to make universal coverage work at the state level, you'd need some way to channel Medicare, Medicaid and other federal healthcare funds into the system. At the moment, that's difficult if not impossible. But legislation quietly being drafted by Rep. Jim McDermott (D-Wash.) would change that. It would create a mechanism for states to request federal funds after establishing their own health insurance programs. If passed into law, McDermott's State-Based Universal Healthcare Act would represent a game changer for medical coverage in the United States. It would, for the first time, create a system under which a Medicare-for-all program could be rolled out on a state-by-state basis.