Progressive Health Care Advances in the Golden State

By SETH SANDRONSKY

In solid-blue California, progressives are working to improve health care. For instance, they protested against GOP Congress members attacking the Affordable Care Act (Obamacare).

Pro-ACA activists rallied at the offices of Republican Congressman Kevin McCarthy, who represents California’s 23rd District in the Central Valley. The weekend after the Senate defeated the GOP’s “skinny” repeal by a 49-51 vote, progressives also protested at the statehouse in Sacramento, one of 125 locations across the US called “Our Lives on the Line.” The coalition urged resistance and vigilance to more GOP attacks on the ACA.

“We have won an important battle in the fight for millions of Americans’ health care, but our fight continues,” said Emma Shapiro, spokesperson for Our Lives on the Line, in a prepared statement. “The morning after his defeat, Trump reminded us he is determined to sabotage Obamacare — promising to hurt people’s health care as revenge for failing to get his win.”

That ACA threat came via a Twitter message from Pres. Trump: “If a new HealthCare Bill is not approved quickly, BAILOUTS for Insurance Companies and BAILOUTS for Members of Congress will end very soon!” The ACA’s estimated $7 billion annual payments to private insurers, or “cost-sharing subsidies,” help low-income folks to pay insurance deductibles and co-payments.

A policy fix to this unstable part of the ACA would make permanent the payments to insurers that Trump threatens to end. Speaking of insurers, progressively, a bid to fix the health system inched forward, with backing from the National Nurses United, a progressive labor union, in the Golden State recently.

State Sen. Toni G. Atkins (D-San Diego) and Sen. Ricardo Lara (D-Bell Gardens) introduced Senate Bill 562 that would have created a government system of a single payer to private doctors and hospitals. SB 562, which would have guaranteed healthcare to all Californians, passed the state Senate this spring. (By contrast, there were 26 million uninsured Americans in 2017, according to the nonpartisan Congressional Budget Office in its analysis of the GOP’s failed bid to replace the ACA with a “skinny” repeal in late July.

Back in California, Atkins’ and Lara’s single-payer bill hit a roadblock in the state Assembly. There, Assembly Speaker Anthony Rendon (D-Los Angeles) stopped discussion of the bill, saying it was “woefully incomplete.” Gov. Jerry Brown (D) critiqued the cost of a single-payer system.

SB 562 will remain in the state Assembly for one more year, but has too many barriers to move forward, according to Don McCanne, M.D., a member of Physicians for a National Health Plan, a single-payer advocacy group. “A single-payer system on the state level requires major federal legislation to move ahead,” he said.

“Since the existing waiver programs do not allow states enough flexibility over use of funds for Medicare, Medicaid and ACA subsidies,” according to McCanne, “we would need federal legislation that would allow California to use those funds for its single-payer program. We would also need relief from the federal Employee Retirement Income Security Act of 1974 law.”

ERISA establishes minimum standards for almost every voluntarily created health and pension plan in private industry (where a majority of workers labor) to protect covered individuals in these plans.

“The ERISA currently limits state oversight of employer-sponsored health plans,” McCanne said. In the meantime, California can lead the national bandwagon on providing Medicare, the government-run health program for Americans age 65 and older, for all,” according to him.

It is worth noting that Vermont’s independent Sen. Bernie Sanders supported expanding Medicare to be a birth-to-death program in his hard-fought campaign against Hillary Clinton to be the Democratic Party’s presidential candidate.

McCanne views a public option whereby the government (federal or state) provides an insurance plan separate from private plans as a weak alternative, due to the money-power of the latter to weaken the former via the US’s pay-to-play political system. That money-and-politics equation explains why the public option never entered the ACA debate before it became law in 2010.

Progressive efforts to improve health care in California show the arduous task of changing a healthcare system that accounts for about one-sixth of the national economy, estimated to be $18.46 trillion last year. One thing is clear. Shifting the healthcare system to one that puts people before profits requires political mobilization and working-class cooperation on a broad scale.

Seth Sandronsky lives and works in Sacramento. He is a journalist and member of the Pacific Media Workers Guild. Email sethsandronsky@gmail.com.

From The Progressive Populist, September 1, 2017

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