THIS TIME ON CODE WACK!
As Trump Administration attacks on public health care ramp up, what’s California doing to fight back? Can the state break free from a system that puts profits over patients — and build a truly universal, single-payer healthcare system? Or will political roadblocks and federal inaction keep us stuck in a broken status quo? Bottom line, how close can California – the 4th largest economy in the world – get to single payer on its own?
To find out, we spoke with Michael Lighty, president of Healthy California Now who has organized, advocated and developed policy for single-payer Medicare for All nationally and in California for over three decades. He’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.
Check out the Transcript and Show Notes for more!
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SHOW NOTES
WE DISCUSS
SB 770 mandated that California Health & Human Services start discussions with the federal government about capturing federal healthcare dollars for a state-based single-payer system. Why are waivers important to this process?
“… you can’t really incorporate those federal monies without permission from the federal government in the form of a waiver.
“How you can integrate Medicare is an ongoing policy question, but there are waiver procedures under the Social Security Act for Medicaid, Medi-Cal, and under the Affordable Care Act.
“So those waiver provisions are available to us, and that’s what we want to talk to the federal government about. The federal government doesn’t want to talk to us, so here we are. ” – Michael Lighty
Since the current administration isn’t interested in discussing state-based single payer, how has this affected California’s progress toward healthcare equity and your work on SB 770?
“SB 770 was, of course … geared toward preparing California to engage … with the federal government over these waivers.
“The other part of it though is to also come up with strategies and programs that could move California toward universal healthcare and would explore what California can do on its own.
So that part of 770 remains alive and that’s what we’re working on. “What are the elements of the current system that California can build on in order to achieve the objectives of creating a single-payer unified financing system and what can we do in the meantime without federal engagement?
“… California’s a big state, I guess the fourth largest economy in the world currently. So you would think there’s a lot that California can do and ultimately we’ll need to engage with the next governor, who will be elected in 2026. And, [who] would be in charge as governor during 2027 and 2028, as that work continues. And so that’s the other task … to lay the groundwork for engaging with the next California administration.
– Michael Lighty
Despite the unfavorable political climate, Senator Bernie Sanders and Rep. Pramila Jayapal introduced updated Medicare for All bills this year. Who else is showing support for single payer in Congress, especially for the states?
“Congressman Ro Khanna has introduced his bill for what they call, state-based universal health care. Senator [Jeff] Merkley from Oregon is doing a counterpart in the Senate. So there is that effort, legislatively.
“I think the federal effort to keep the issue prominent and to keep the national demand for Medicare for All is very important, Improved Medicare for All as we say. We’ve gotta have an alternative to what the current federal administration’s doing, and that alternative is not taking 8 to 13 million people off of healthcare and basically killing some number of people because they don’t have healthcare.
It’s just absolutely tragic and horrific. The alternative to that is to guarantee healthcare for everybody and improve Medicare for All. So that’s gotta be our objective…” – Michael Lighty
Helpful Links
Newsom signs bill advancing universal health care, vetoes insulin price cap, CBS News
California Enacts Statute That Furthers Efforts to Move Toward a Unified Health Care Financing System, Epstein, Becker, Green
State Health Care Reform: Waivers, Single-Payer, and the Need for Alternative Pathways, Annals of Internal Medicine
The Case for State-Based Single-Payer Healthcare, Common Dreams
States as Policy Laboratories: The Politics of State-Based Single-Payer Proposals, American Journal of Public Health
Trump pledged not to cut Medicare – but his budget bill does just that, Morningstar/Dow Jones
Medicaid Faces ‘Reset Moment’ Under Trump, CPA Practice Advisor
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 most recently, he was the Healthcare Constituency Director for Bernie 2020.
Formerly he was director of public policy for the California Nurses Association/ National Nurses United. He was lead policy analyst, a leader of Campaign for a Healthy California and testified on behalf of the single-payer bill, SB 562.
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