Rep. Jim McDermott (D-WA) will soon introduce legislation that would allow states to use federal funds they’re receiving through Medicare, Medicaid, and other health care programs to build a universal single-payer system. Advocates are describing the bill as a “lifeline” for advocates:

It would create a mechanism for states to request federal funds after establishing their own health insurance programs…. 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. In California’s case, it would make coverage available to the roughly 7 million people now lacking health insurance. “This is a huge deal,” said Jamie Court, president of Consumer Watchdog, a Santa Monica advocacy group. “This is a lifeline for people who want to create a Medicare system at the state level.”

The bill could warm the hearts of liberals who expressed frustration with the Affordable Care Act’s more moderate approach of building on the existing health care system and should also satisfy GOP presidential candidate Mitt Romney. The former Massachusetts governor has sought to differentiate his 2006 health reform from Obamacare by rejecting a federal prescription for reform and promising to “pursue policies that give each state the power to craft a health care reform plan that is best for its own citizens.”

The ACA creates state flexibility by granting waivers to states that meet certain coverage standards and a bipartisan group of lawmakers has offered legislation expanding the provision by allowing states with innovative health care solutions to opt out of certain provisions beginning in 2014. Romney, meanwhile, has pledged to build on the ACA’s flexibility and grant states to the ability to opt out of the law entirely.

McDermott’s measure would go even further and encourage states to repurpose federal funds to build a universal single-payer health system of their own. If Republicans are truly interested in states rights, they will back it in mass.