The counterplan gets struck down, out of funding, and unequal.

Industry leaders say the impact of a state- or regional-level single-payer system on self-insured large group plan holders and Medicare beneficiaries would make choosing uniform plans difficult, raising the issue of some beneficiaries receiving more comprehensive coverage than those in other states.

James Klein, president of the American Benefits Council, says that any reform of the U.S. health coverage system should build on the employer-sponsored system covering nearly 180 million Americans to ensure that employees of multi-state companies receive the same benefits as co-workers in other states.

Tim Jost, a healthcare policy expert and law professor emeritus at Washington and Lee University, also labels ERISA plans as a "major barrier" to a state-level single-payer system because the federal government currently retains control of those plans, and many employers choose benefits for employees across different states.

The ERISA Industry Committee, a nonprofit that represents employee benefits interests of large employers, declined to comment on the bill.

Another hurdle for a successful system is coming up with a way to fund the plans using a similar percentage to current federal funding. Jost says that Medicare typically receives the most federal funding out of the programs included, so he predicts that program would have to redistribute funding to others.