THIS TIME ON CODE WACK!
What if California, Oregon, and Washington joined forces to win federal approval for universal, single-payer healthcare? Could a united West Coast shift the balance of power in America’s healthcare debate?
To find out, we recently spoke with Michael Lighty, president of the single-payer advocacy coalition Healthy California Now. Michael ’s a founding fellow of the Sanders Institute, and he was healthcare constituency director for the Bernie 2020 campaign. Most recently, he co-wrote and was a leader in the successful campaign to enact California’s Senate Bill 770, a critical step toward negotiating the federal waivers the Golden State needs to build a universal, publicly financed healthcare system.
Join us as we explore how these three states are moving to collaborate toward a common goal — and why this could be a game-changer for patients, politics, and policy nationwide.
Check out the Transcript and Show Notes for more!
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SHOW NOTES
WE DISCUSS
Single-payer advocates in California, Oregon, and Washington have been talking or meeting regularly about securing federal waivers for a universal healthcare system in their respective states. Does this mark the start of a real West Coast partnership?
“Well, I certainly hope so. And it looks like it is shaping up to be, I mean, Oregon, California and Washington State are pursuing a parallel track. Each state has had some form of a commission, [and] that commission has generated some follow up program.
In the case of Oregon, it’s the Universal Healthcare Governance Board. In the case of Washington State, it’s the Universal Health Care Commission.
And in both of those states, they are considering the design of a system that provides health care to all residents of their states. In Washington, it’s a system that is referred to as unified financing. In Oregon, it’s single-payer financing. I think it’s generally understood that those are talking about the same thing. Both of them use the word universal. Right? You’ll see Universal Healthcare Governance Board, mission. So, and of course, we’re all wrestling with the same policy questions. Who’s covered? What are the benefits? Who pays? How is it governed?” – Michael Lighty
What’s the real advantage of joining forces with these other states rather than going it alone?
“Well, the advantage is we’re all dealing with the same issues. I mean, you know, you look at this and it’s like, well … is there gonna be cost sharing? You know, that is [what] our patients are gonna pay in addition to whatever, you know, public revenues they pay into.
“Are they gonna pay additional amounts as cost sharing? What benefits are there gonna be?
“… Each state is having to address the same issues. Each state is engaging in a community outreach project. Each state is, you know, dealing with comments and working with different stakeholders. Each state is gonna have to have the legislature approve it, as I said, and the governor plays a leading role in each case.
“So the politics, the policy, the financing, the process [are] virtually the same.” – Michael Lighty
How do you see the California-Oregon-Washington collaboration influencing the national single-payer movement in the years ahead?
“I think the real advantage for this collaboration will first come when we can go to the federal government in an a coordinated way, when we have the opportunity to do so, so that we can, if we can align our preparation and then be ready, hopefully in 2029 to talk to a Democratic administration, that will be, I think, extraordinarily powerful in terms of advocating for the best deal with the feds.
“And also very efficient, right, in terms of getting a response ’cause the federal government’s unlikely to say things substantially different to each state.
“And then the second advantage, of course, is going to the ballot together.
So I think we should take those opportunities seriously, and figure out how to maximize the political impact of this coordination.
“We have the time. I mean the silver lining — God help us — of not discussing with the feds now, is that we have time to develop this collaboration, to develop our state-based programs and to strengthen our political power so that we’re in the strongest position to go through the state legislators, and then go to the federal administration.” – Michael Lighty
Helpful Links
Universal Healthcare Governance Board (Oregon)
Universal Health Care Commission (Washington State)
State lawmakers leading new charge for single-payer care, The Nation’s Health, the American Public Health Association
Tracking The Trump Administration’s Early Deregulation Agenda, Health Affairs
How New Federal Legislation Will Affect Health Care Costs and Access for Americans, Johns Hopkins Bloomberg School of Public Health
Episode Transcript
Read the full episode transcript.
Biography: Michael Lighty
Michael Lighty, President, Healthy California Now, has organized, advocated and developed policy for single-payer, Medicare for All nationally and in California for over 30 years.
He is a founding Fellow of the Sanders Institute, and he was the Healthcare Constituency Director for Bernie 2020. He is a consultant for the National Union of Healthcare Workers.
Most recently, he co-wrote and was a leader in the successful campaign to enact CA SB 770. He worked for 25 years for the California Nurses Association/ National Nurses United, including as the director of public policy.
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