The Tea Party Helped Build the Bridge to Single-Payer By pushing a draconian repeal of Obamacare, they awakened a giant. Thanks, guys!

March 31, 2017

By Richard Kim

MARCH 29, 2017

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The Tea Party Helped Build

the Bridge to Single-Payer

By pushing a draconian repeal of Obamacare, they awakened a

giant. Thanks, guys!

I n September 2011, a little over two years into its

existence and fresh off some high-profile victories in

the midterm elections, the Tea Party hosted its first

Health-care-justice advocates outside Trump Tower in New York on

January 13, 2016. (Sipa USA via AP)

presidential debate in Tampa, Florida. Late in the

evening, CNN moderator Wolf Blitzer asked

Congressman Ron Paul, a physician by training, what

should happen to a 30-year-old healthy young man who

decides to forgo insurance but then becomes

catastrophically ill. “Who’s going to pay if he goes into a

coma, for example?” Blitzer inquired.

Paul rattled off some libertarian bromides about the evils

of “welfarism and socialism” and how “freedom is all

about taking your own risks.” Unsatisfied, Blitzer drove

home the point: “But Congressman, are you saying that

society should just let him die?” At which point, the

audience burst into applause, as several members roared

out “Yeah!” followed by all-around laughter. It was a

stunning moment, spiked with instant and unfaked

schadenfreude, that caused even Paul to blink back

surprise and that overshadowed anything else on the

stage that night. (The debate’s other newsworthy moment

came when then-front-runner Rick Perry was jeered for

defending the HPV vaccine.)

The GOP’s ignominious withdrawal of the American

Health Care Act, backed by President Trump and House

Speaker Paul Ryan, brought this insurrectionary moment

full circle. Rebranded and purified as the House Freedom

Caucus, the Tea Party’s hard-core members took Ryan’s

already shoddy proposal—including a giant tax cut for the

super-wealthy and the end of coverage for some 24

million Americans—and extracted concessions that would

have made it remarkably worse. The caucus insisted on

gutting the requirement that insurance companies offer

essential benefits, permitting them to sell junk plans. As

the clock wound down on negotiations, it was still holding

out in the hope of repealing Obamacare’s most popular

provisions, which allow young adults to stay on their

parents’ plans and require coverage of patients with

preexisting conditions. The resulting monstrosity would

have simply allowed millions of sick Americans to die.

Moderates bolted, even as the Freedom Caucus refused to

budge. And so ended, at least for now, the Republican

Party’s abiding obsession with abolishing Obamacare.

“A complete disaster!” as Trump might say. But one richly

earned. Since the first year of Obama’s presidency, the

Republican establishment has allowed its extreme rightwingers

to run off the leash. It has amplified their every

outburst, fed every conspiracy theory, nurtured every

grievance, and enabled every act of hostage-taking. Now,

it—and the vandal in chief that the Tea Party helped elect

president—is their hostage. In the battles ahead on

infrastructure spending, taxation, and the debt ceiling,

there’s no reason to believe that the GOP will behave in

any less dysfunctional a manner.

Given this self-inflicted gridlock, Democrats may be

tempted to let the Republicans implode and live with the

status quo. This would be a catastrophic mistake. The

grassroots uprisings that swarmed congressional town

halls with angry constituents were not, at their core, a

defense of Obamacare’s particulars. “Keep your hands off

my Affordable Care Act premium tax credit!” protested

nobody, ever. The 25-year-olds who raged at the prospect

of getting kicked off their parents’ plans, the senior

citizens worried about out-of-control costs, the patients

anxious about preexisting conditions, were expressing a

much more profound belief: that health care is a

fundamental right.

Obamacare falls far short of that mark. The fact that it

has become more popular—49 percent of Americans now

support it—as more people have used and understood it

should come as no surprise. That was always its design.

The more unexpected turn of events is that significant

majorities of Americans—and 41 percent of Republicans

in one poll—now support a single-payer plan. To that end,

in the coming weeks, Senator Bernie Sanders plans to

reintroduce his Medicare for All bill, an idea that has

backers in both expected (Keith Ellison, John Conyers)

and unexpected quarters: Nancy Pelosi, Obama- care’s true

architect, recently told a questioner at a town hall, “I

supported single payer since before you were born.” More

importantly, the citizen coalition to defend Obamacare—

backed by Planned Parenthood, the AARP, MoveOn, Our

Revolution, the chapters of Indivisible, and others—is

amped up to push for its passage. In 2009, the Obama

administration purposefully tamped down that energy,

preferring to run an inside game. But with Trump in the

White House and the Freedom Caucus bullying Congress,

the only game now is on the outside.


Along the way, Democrats must continue to defend the

current law. Trump’s promise to “let Obamacare explode”

was not an empty threat. Already he’s appointed two

leading saboteurs to head key agencies: Tom Price at the

Department of Health and Human Services and Seema

Verma at the Centers for Medicare and Medicaid

Services. Together, they could radically reduce subsidies

to insurance companies, causing more to leave the

exchanges; discourage enrollment and weaken

enforcement of the individual mandate; undermine

Medicaid by allowing states to impose premiums and

work requirements; and reinterpret what qualifies as an

essential benefit, letting insurance companies offer

stingier plans. These changes will come wrapped in a

thick fog of bureaucracy—and it’s up to progressives to

expose and humanize what’s really happening. We also

need to counter each proposed cut with an alternative

plan to expand and improve coverage: to extend

Medicaid, increase subsidies, elevate insurance standards,

and lower the Medicare eligibility age to 50, as Senator

Jeff Merkley has proposed.

Taken together, these steps would grow the public aspects

of Obamacare while reducing its reliance on private

markets. When the bill was first passed, centrist

Democrats placated its critics on the left by claiming that

Obamacare could act as a bridge to a single-payer system.

Wouldn’t it be amazing if that actually came true—and if

the Tea Party helped make it happen? •

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RICHARD KIM Richard Kim is the executive editor of The Nation.

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March 31, 2017


This morning on WNYC, Brian Lehrer, during a live interview to which I was listening, asked Mayor DeBlasio if he supported the state single payer initiative since it was now just a few votes shy of sufficient Senate support in Albany. He answered with a full-throated, unequivocal endorsement, praised Dick Gottfried for his efforts, reminded listeners of Bernie Sanders advocacy of single payer, and endorsed it also because it is a positive strategy to counter the right, and not just a defensive tactic.
Gene Carroll| The Worker Institute at Cornell
Co-Director, Union Leadership Institute
ILR School, Cornell University
16 East 34th Street, 4th Floor, New York, NY 10016
Office: 212.340.2853
Email: | Skype: genecarrollcornell

New York State Inches Closer To Single-Payer Plan With Pickup Of New Support

March 31, 2017

But critics wonder whether the additional backing is merely symbolic.

The push to implement a “Medicare for all”-type system in New York state just took a significant step forward Wednesday. Sen. Jeffrey Klein, who heads the Independent Democratic Conference in the state Senate, plans to co-sponsor the measure, and will bring along the remaining holdout in his caucus, his spokeswoman Candice Giove told The Huffington Post.

That gives the measure the unanimous support of the IDC, a crucial, and often recalcitrant, bloc of lawmakers. “All members of the independent conference will become cosponsors of that bill,” Giove said.

In a statement, Klein cited President Donald Trump’s attempts to repeal the Affordable Care Act and the protections it provides as a reason he is backing the creation of a single-payer health insurance system in New York.

“A single-payer system would create the peace of mind that residents could have access to quality medical care including outpatient and inpatient medical care, primary and preventive care, prescription drugs and laboratory tests,” Klein said.

The New York Senate is a strange place. With 63 seats, 32 senators are needed for a majority. Republicans have only 31, but an additional Democrat, Sen. Simcha Felder, caucuses with Republicans, giving them control of the chamber. Meanwhile, the eight members of the IDC do not caucus with the rest of the Democrats.

Sen. Michael Gianaris, the deputy leader of the state Senate’s mainstream Democratic conference, welcomed the IDC’s support, even as he lamented that their collaboration with Republicans helped prevent the bill’s passage.

“It’s nice that they are putting their names on the bill, but their partners in government are the ones with the power to prevent it from seeing the light of day,” Gianaris said.

Although Republicans have the majority without the IDC, thanks to Felder, Gianaris believes the breakaway caucus has made the problem worse.

“With the Democrats being divided in the Senate, we lose the ability to pressure Felder to come back or grow the conference in other ways, because we’re too busy dealing with each other,” Gianaris said.

But the support of the IDC is a critical development in the push for single-payer health care, as the state assembly is expected to easily pass its version of the bill in April or May, said one of the bill’s lead backers, Assemblyman Jeffrey Dinowitz, who represents the northwest Bronx.

The New York Assembly, the state’s lower legislative chamber, passed the same measure in 2015 and 2016, but it wasn’t considered in the state Senate, which Republicans control with the support of the Independent Democratic Caucus.

Despite being within striking distance of passing the single-payer bill in the New York Senate, victory for its proponents seems unlikely given GOP opposition. Rallies are planned in support of single-payer health care in New York City Saturday and Albany, the state capital, Tuesday.

New York State Sen. Jeffrey Klein, leader of the breakaway Independent Democratic Caucus, has announced his support for a single-payer health insurance bill.

It is not clear why IDC members chose this time to get behind legislation introduced by Sen. Gustavo Rivera, a member of the mainstream Senate Democratic caucus ― particularly since Republican control of the chamber forecloses the bill’s passage.

There are signs that the IDC is feeling pressure from a progressive Democratic base newly energized by Trump’s election. Over 100 protesters booed Sen. Jose Peralta for his IDC membership outside a February town hall in Queens. Anti-IDC activists have even formed their own group, “No IDC NY,” to oppose the renegade Democrats.

“The IDC has been feeling enormous pressure since the inauguration from voters in their districts who were shocked to find out the Democrats they elected have been propping up Trump Republicans in the state Senate,” Bill Lipton, the Working Families Party’s New York director, said in a statement. “Now they’re backing legislation that their own support of Republican leadership ensures will never even make it to the floor. That’s the height of cynicism and just more evidence of the heat they are feeling from the resistance.”

Whatever the outcome in New York, the failure of President Donald Trump and House Speaker Paul Ryan (R-Wis.) to repeal the Affordable Care Act and replace it with an alternate plan that would increase the number of uninsured Americans by 24 million has given a boost to progressives seeking to go beyond Obamacare.

Legislators in California have launched a new push to implement a single-payer program in the most populous state in the nation, although Democratic Gov. Jerry Brown has expressed misgivingsabout its cost.

The Affordable Care Act contains a provision that would allow states to make sweeping changes to their health care markets, including instituting a single-payer program that would replace the current private system, so long as the state programs cover as many people with equivalent benefits at no additional cost to the federal government. Vermont worked for several years after the Affordable Care Act’s passage to design a single-payer program, but abandoned the effort over its expense.

In the wake of Trump being elected, the issue of health care has moved to the top of the agenda for a lot of people.New York Assemblyman Jeffrey Dinowitz

Excluding the IDC, the mainstream Democrats hold 22 seats in the New York state Senate and will soon hold 23 once a special election is held in a Democratic district.

But even with all mainstream Democrats and the IDC on board, they would remain one vote short, meaning Democrats need to either pick up a seat before 2018, persuade a Republican or win the chamber outright in 2018. This being New York, a Republican senator was coincidentally indicted just last week, so it’s always possible a new seat could become available.

If not, said Dinowitz, his hope is that the newfound energy among grassroots Democrats can translate into some Senate seat pickups in 2018. “We need to add one more person. I believe the only way to get to 32 is through the election process,” Dinowitz said. “There is a lot of energy now in my area and other areas. Meetings are attracting huge numbers of people, and a lot of people are coming out, most of whom have never been involved in this way. If it’s sustained it could really change the dynamics of the elections come 2018.”

Controlling the chamber is also crucial because the party in power controls the floor schedule. Even if Democrats persuaded a Republican to sign on, they’d need to similarly persuade the Republican leadership to allow a vote.

Dinowitz said that groups affiliated with Indivisible, a grassroots activism network that arose after the election, have been particularly active on the single-payer issue, and that in meetings with new activists, the number one issue they care about is health care, followed closely by immigration.

“In the wake of Trump being elected, the issue of health care has moved to the top of the agenda for a lot of people. If people think we can rest on our laurels because repeal of Obamacare collapsed, they’re mistaken. Obamacare was a compromise of a compromise,” Dinowitz said, noting that not only was it not the single-payer system many prefer, but the public option was traded away.

If both California and New York can implement a single-payer heath care system in the next few years, he added, something like a fifth of the country will be covered just by those two states.



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