Advocates renew push for government-run care
Legislative efforts on health coverage falter in Calif., N.Y.
As Republicans push changes to reduce the government’s role in health care, some opponents are emboldened in their support for the opposite approach, one that would greatly increase government involvement.
Liberal politicians and activists see a future in single-payer health care, the term for a government-run health insurance program that would be available to any American. Though a Democratic-backed federal bill has no future in the GOP-led Congress, backers have tried at the state level.
After the election of President Trump, Jimmi Kuehn-Boldt of Palm Springs, Calif., began advocating for single-payer health care with the grass-roots group Courageous Resistance. At 63, he doesn’t expect anything to take effect before he’s eligible for Medicare in a little more than a year, but he said he’s worried about seeing care for others deteriorate.
The Senate proposal to overhaul the Affordable Care Act makes any talk of single-payer, either in Washington or Sacramento, “just as important, if not more than before,” he said.
“We’ve got to see how it’s fleshed out in Washington, but we can still move forward here,” Kuehn-Boldt said.
More than 100 Democrats in the House of Representatives signed on to a single-payer bill introduced by Rep. John Conyers of Michigan called Medicare for All because it would eliminate the 65-and-older requirement for Medicare. Sen. Bernie Sanders, I-Vt., has talked about introducing his own plan.
In California, where Democrats hold strong majorities and the governorship, a bill that would create a statewide singlepayer program passed the state Senate on June 1. That momentum stalled when state Assembly Speaker Anthony Rendon, a Democrat, announced he was holding the bill in committee until further notice. In a statement, Rendon called the bill, SB 562, “woefully incomplete.”
“Even senators who voted for SB 562 noted there are potentially fatal flaws in the bill, including the fact it does not address many serious issues, such as financing, delivery of care, cost controls or the realities of needed action by the Trump administration and voters,” Rendon said.
The plan would provide broad coverage, including the essential health benefits spelled out in the Affordable Care Act. The bill states that enrollees would not pay co-payments or deductibles.
State Sen. Toni Atkins of San Diego, one of two Democratic sponsors of the bill, said that even if the ACA remains intact, the state can do more to cut costs and improve access.
“We will continue to demand the quality health care we all deserve,” Atkins said. “If Congress passes this bait-and-switch, we will fight here at home to ensure that Californians remain covered.”
Price remains a major question for California’s plan and has made the bill a non-starter for some Republican lawmakers. A recent estimate put the cost at $400 billion annually, half of which would need to come from new revenue.
Lawmakers in New York have been hammering out their own single-payer plan. The state’s legislation, called the New York Health Act, passed the Democrat-led Assembly three times before 2017, but it repeatedly stalled in the Republican-leaning Senate, which represents more rural Upstate New York vs. the urban New York City metro area and mirrors the U.S. political divide.
Debate over federal health care law this year prompted a renewed push to pass the New York Health Act, but it once again passed the state Assembly only to die in the Senate.
New York Assemblyman Richard Gottfried, a Democrat from Manhattan, has championed the single-payer push in his state. He described it as an example for states to expand the federal Medicare program for the elderly to the entire population.
“What is going on in Washington is making it clearer than ever that the only way Americans can get access to health care is through Medicare-for-all legislation starting in the states,” Gottfried said.
Oliver Fein, chairman of the New York metro chapter of a single-payer advocacy group called Physicians for a National Health Program, focused on Republican-led efforts to cut money for Medicaid, the joint state-federal health program for millions of poor and disabled. “That is likely to be a huge destabilizing factor not just for the patients themselves, the people who will be denied coverage, but frankly for the whole hospital system because hospitals really do depend on Medicaid income,” Fein said.