It'll start at the state level with single payer probably through medicaid expansion (medicaid for all). If the Feds aren't on board then you won't get the 50%

It'll start at the state level with single payer probably through medicaid expansion (medicaid for all). If the Feds aren't on board then you won't get the 50% match from the Feds but the premiums should help offset that. You might then get a few states who band together. What will happen next is that a lot of people will move to those states (as jobs permit) resulting in an economic bonanza for those states.